Int J Thyroidol.  2016 Nov;9(2):174-179. 10.11106/ijt.2016.9.2.174.

Two Cases of Graves' Disease Presented with Atypical Symptoms

• Yoo WS
• Chung HK

• KMID: 2362354
• DOI: http://doi.org/10.11106/ijt.2016.9.2.174

Abstract

We describe here two Graves' patients who have presented with atypical symptoms. Interestingly, both of them had symptoms related to imbalance of body fluid homeostasis. Chief complaint of a 35-year-old woman (case 1) was the ipsilateral edema of upper body. A 33-year-old man (case 2) who had severe polyuria has referred from urology department with impression of diabetes insipidus. Both of them denied any typical symptoms of Graves' disease at presentation. These rare extrathyroid manifestations of Graves' disease were completely subsided after antithyroid drug treatment. We introduce their clinical courses and possible pathophysiological mechanisms of the atypical symptoms of Graves' disease.

Keyword

Graves' disease; Edema; Polyuria

MeSH Terms

Adult
Body Fluids
Diabetes Insipidus
Edema
Female
Graves Disease*
Homeostasis
Humans
Polyuria
Urology

Figure

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  Fig. 1. Left dominant ipsila-teral edema of upper ex-tremity (case 1) at presen-tation (A), after 6 months antithyroid drug treatment (B).

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  Fig. 2. Computed tomography of the case 1. Initial CT scans (A) showed diffuse increased soft tissue density in anterior mediastinum (A. long arrows), multiple lymph node enlargement in left axillary (A. short arrow) and ipsilateral edema in upper trunk (B). Follow-up CT scans after 6 months antithyroid drug treatment showed significantly decreased extent of soft tissue density in anterior mediastinum (C. long arrows), lymph node enlargement in left axillary (C. short arrow) and improved edema in upper trunk (D).

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  Fig. 3. Thyroid uptake (Tc-99m) scan of case 1 (A) and case 2 (B).

Reference

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