J Korean Soc Endocrinol.  2005 Feb;20(1):78-83. 10.3803/jkes.2005.20.1.78.

Two Cases of Apathetic Hyperthyroidism associated with Peripheral Eosinophilia

• Kim MJ
• Yoo KH
• Kim BK
• Chang WC
• Yeon JH
• Shin SY

• KMID: 2100456
• DOI: http://doi.org/10.3803/jkes.2005.20.1.78

Abstract

Peripheral eosinophilia is perpetually associated with many disease conditions like asthma, parasitic disease, IL-2 therapy, hypereosinophilic syndrome and eosinophilia/myalgia syndrome. Furthermore, peripheral eosinophilia may also be linked with Graves' disease, which is induced by thyroid-stimulating anti-TSH receptor antibodies and is related to type 2 helper T cell(Th2) predominant condition that is dependent on humoral immunity. In some of the cases of Graves' disease, thyrotoxicosis may induce peripheral eosinophilia associated with relative cortisol deficiency. In our present study, we present a case of two patients who were suffering from Graves' disease without any thyrotoxic symptoms and exhibited increased levels of peripheral eosinophil count. But, the count was observed to decreas in euthyroid state.

MeSH Terms

Antibodies
Asthma
Eosinophilia*
Eosinophils
Graves Disease
Humans
Hydrocortisone
Hypereosinophilic Syndrome
Hyperthyroidism*
Immunity, Humoral
Interleukin-2
Parasitic Diseases
Thyrotoxicosis
Antibodies
Hydrocortisone
Interleukin-2

Figure

• 

  Fig. 1 Thyroid sonogram shows slightly enlarged both thyroid glands

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  Fig. 2 99mTc-O4 thyroid scan shows mild diffuse enlargement with increased uptake (case 1).

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  Fig. 3 Blood eosinophil counts are decreased after antithyroid drug medication (case 1)

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  Fig. 4 99mTc-O4 thyroid scan shows diffuse enlargement with increased uptake (case 2).

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  Fig. 5 Blood eosinophil counts are decreased after antithyroid drug medication (case 2).

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