Persistent hyperthyroidism and de novo Graves' ophthalmopathy after total thyroidectomy. (13th October 2017)

• Record Type: Journal Article
• Authors: Tay, Wei Lin; Loh, Wann Jia; Lee, Lianne Ai Ling; Chng, Chiaw Ling
• Is Part Of: Endocrinology, diabetes & metabolism case reports. (2017)
• Publication Date: 2017-10-13
• Subjects: Adult -- Female -- Asian - Chinese -- Singapore; Thyroid -- Thyroid -- Thyroxine (T4) -- Triiodothyronine (T3) -- TSH -- Hyperthyroidism -- Graves' ophthalmopathy -- Graves' disease -- Struma ovarii -- Thyrotoxicosis -- Goitre (multinodular) -- Thyroiditis -- Ovarian tumour; Hyperthyroidism -- Thyrotoxicosis -- Fatigue -- Myasthaenia -- Palpitations -- Menstrual disorder -- Tremulousness -- Weight loss -- Heat intolerance -- Goitre -- Dysphagia -- Bowel movements ȃ bleeding -- Diplopia -- Proptosis -- FT3 -- FT4 -- TSH -- TSH receptor antibodies -- CT scan -- Thyroid antibodies -- MRI -- Histopathology -- Thyroidectomy -- Salpingo-oophorectomy -- Hysterectomy -- Resection of tumour -- Bilateral salpingo-oophorectomy -- Carbimazole -- Levothyroxine -- Prednisolone -- Glucocorticoids; Unique/unexpected symptoms or presentations of a disease -- October -- 2017; Endocrinology -- Periodicals; Diabetes -- Periodicals; Diabetes Mellitus; Endocrinology; Diabetes; Endocrinology; Case Reports; Periodicals; Periodicals; 616.4
• DOI: 10.1530/EDM-17-0109
• Languages: English
• ISSNs: 2052-0573

Abstract

Summary: We report a patient with Graves' disease who remained persistently hyperthyroid after a total thyroidectomy and also developed de novo Graves' ophthalmopathy 5 months after surgery. She was subsequently found to have a mature cystic teratoma containing struma ovarii after undergoing a total hysterectomy and salpingo-oophorectomy for an incidental ovarian lesion. Learning points: It is important to investigate for other causes of primary hyperthyroidism when thyrotoxicosis persists after total thyroidectomy. TSH receptor antibody may persist after total thyroidectomy and may potentially contribute to the development of de novo Graves' ophthalmopathy.