Rapid Changes of Thyroid Function in a Young Woman with Autoimmune Thyroid Disease

[helvella]

Interesting that TRab were not detected at first test. And amazing they looked again!

Med Princ Pract. 2019 Mar 22. doi: 10.1159/000499754. [Epub ahead of print]

Rapid Changes of Thyroid Function in a Young Woman with Autoimmune Thyroid Disease.

Trummer C, Schwetz V, Aberer F, Pandis M, Lerchbaum E, Pilz S.

Abstract

Objective

A conversion from Hashimoto's thyroiditis (HT) to Graves' disease (GD) and vice versa leads to diagnostic and therapeutic challenges.

Clinical Presentation and Intervention

A 30-year old woman presented with overt hyperthyroidism and negative thyroid-stimulating hormone receptor antibodies (TRAbs). Since hashitoxicosis was assumed, the patient was treated with propranolol. Within the next few weeks, the patient developed severe overt hypothyroidism, leading to treatment with levothyroxine. However, after several more weeks, the patient presented with overt hyperthyroidism once again, this time also showing elevated TRAbs.

Conclusion

We suggest educating patients and physicians to recognize changes in thyroid function and close monitoring of unclear cases of overt hyperthyroidism.<br>.

©2019The Author(s). Published by S. Karger AG, Basel.

PMID: 30897565

DOI: 10.1159/000499754

ncbi.nlm.nih.gov/pubmed/308...

[shaws Administrator]

I like the fact that they commented 'patients' first i.e.

"Conclusion

We suggest educating patients and physicians to recognize changes in thyroid function and close monitoring of unclear cases of overt hyperthyroidism.".

This post is very informative.

[SilverAvocado in reply to shaws]

And that they understand Hashimotos can cause hyper looking bloods. I don't think I've ever heard of a doctor on this forum knowing that!

[shaws Administrator in reply to SilverAvocado]

Neither do the ones at the top who just removed NDT then T3. Not caring one iota of the stresses caused to patients who were leading a healthy/fruitful life.

[TSH110]

Poor woman - she must have felt truly dreadful. I had a really rapid swing like this but only got back to overt hypothyrodism no more thyroid left for any more hyperthyroid episodes. I was so out of it I was beyond any education I had no idea what was going on just getting to the next moment was a challenge and I felt like I was in the artic. At least the medicos seem to have realised what was going on and got me on Levothyroxine. It was never really explained to me what all that was about - bar the TSH feedback loop applying to the hypothyroid phases only which was well explained by my GP, given my poor mental state at that juncture - until I read stuff on here about the autoimmune implications and had regained some cognitive capacity again did I begin to properly comprehend the progression. What a roller coaster ride....