Clin Ultrasound.  2017 Nov;2(2):60-63. 10.18525/cu.2017.2.2.60.

Graves' Disease Following Recurrent Subacute Thyroiditis

• KMID: 2555370
• DOI: http://doi.org/10.18525/cu.2017.2.2.60

Abstract

Subacute thyroiditis is a spontaneously remitting inflammatory disease that is probably caused by viral infection. Graves' disease following subacute thyroiditis is rarely reported. However, Graves' disease following recurrent subacute thyroiditis is not reported. A 47-year-old woman referred to our center for fine needle aspiration of thyroid nodule. Laboratory tests showed normal FT4 , low thyroid stimulating hormone (TSH) and elevated erythrocyte sedimentation rate. A Tc-99m scintigraphy showed nonvisualization of left thyroid gland and 24-hour radioactive iodine uptake was 2.1%. A thyroid ultrasound (US) revealed focal ill-defined hypoechoic areas. Symptoms subsided with glucocorticoid treatment. Two years later, she complained anterior neck pain and diagnosed recurrent subacute thyroiditis. After two years, she had Graves’ disease developed with elevated serum thyroid hormone and TSH receptor antibody. A doppler US showed increased vascular flow in both thyroid lobes. She was treated with methimazole with relief of symptoms and signs of hyperthyroidism.