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Case Reports
. 2018;33(2):190-193.
doi: 10.15605/jafes.033.02.12. Epub 2018 Nov 2.

Conversion of Primary Hypothyroidism to Hyperthyroidism: A Case Report

Liam Clifford  1 , Ammar Wakil  2
Affiliations
Case Reports

Conversion of Primary Hypothyroidism to Hyperthyroidism: A Case Report

Liam Clifford et al. J ASEAN Fed Endocr Soc. 2018.

Abstract

A 51-year-old Caucasian male developed Graves' thyrotoxicosis following long-standing treatment for hypothyroidism. After a short period of treatment with carbimazole, he developed agranulocytosis and required total thyroidectomy. In this relevant case report, we review several pathogenetic mechanisms that explain the transformation of autoimmune hypothyroidism into Graves' disease and the possible approaches to the management of agranulocytosis secondary to antithyroid medications. Further studies are required to determine the best way to manage severe thyrotoxicosis when agranulocytosis develops due to antithyroid medications.

Keywords: Graves’ disease; agranulocytosis; antithyroid drugs; carbimazole; hypothyroidism.

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Conflict of interest statement

The authors declared no conflict of interest.

Figures

Figure 1
Figure 1
Ultrasound of the thyroid gland showing heterogenous echogenicity of the tissue parenchyma (A) and increased vascularity (B).
Figure 2
Figure 2
Thyroid scan showing increased pertechnetate uptake.
Figure 3
Figure 3
Histopathologic examination of the excised thyroid showed diffuse hyperplasia characterized by prominent scalloping in the thyroid follicles (H&E, 10x).
Figure 4
Figure 4
Histopathologic examination of the thyroid further revealed a background of chronic lymphocytic thyroiditis with lymphoid aggregates complete with germinal centres (H&E, 10x) (A) and oncocytic metaplasia with thyroiditis (H&E, 200x) (B).
See this image and copyright information in PMC

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