아급성 갑상선염 후 발병된 그레이브스병 1예
A Case of Graves’ Disease Occurring after Subacute Thyroiditis
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초록
아급성 갑상선염 이후에 발생한 자가면역항체 양성인 그레이브스병은 발생 빈도가 낮고, 짧은 기간 치료만으로 정상으로 돌아오는 경우가 많다고 알려져 있다. 하지만 본 증례에서는 아급성 갑상선염을 치료 후 호전되었다가 갑상선자극호르몬수용체항체 양성인 그레이브스병이 발생하였고, 예외적으로 수년 동안 치료가 필요할 수도 있음을 보여주었다.
Abstract
Graves’ disease following subacute thyroiditis is uncommon. Some patients in these cases showed positive for thyroid antibody only transiently in the resolving phase. However, Graves’ disease can rarely be caused by the presence of antibodies after subacute thyroiditis, although the pathophysiology of this is unclear. A 40-year-old woman presented with anterior neck pain and swallowing difficulty. Thyroid function testing showed reduced thyroid-stimulating hormone (TSH) and elevated free thyroxine levels. A thyroid scan revealed decreased uptake in the bilateral thyroid gland. The patient was initially diagnosed with subacute thyroiditis and treated with steroids. Five months later, thyroid function testing showed recurrent hyperthyroidism with positive conversion of TSH receptor antibody, indicating Graves’ disease. Since then, she needed the long-term methimazole treatment. In summary, we herein report a case of Graves’ disease occurring after subacute thyroiditis.
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