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Case Reports
. 2022 Aug 5;14(8):e27715.
doi: 10.7759/cureus.27715. eCollection 2022 Aug.

Fluctuating Hyperthyroidism and Hypothyroidism in Graves' Disease: The Swinging Between Two Clinical Entities

Aakriti Shrestha  1 , Namrata Adhikari  1 , Saujan Devkota  1 , Tutul Chowdhury  1 , Zewge Shiferaw-Deribe  2 , Nicole Gousy  3 , Samaj Adhikari  1
Affiliations
Case Reports

Fluctuating Hyperthyroidism and Hypothyroidism in Graves' Disease: The Swinging Between Two Clinical Entities

Aakriti Shrestha et al. Cureus. .

Abstract

Autoimmune thyroid disorders are frequently encountered in clinical practice and consist of a spectrum ranging from Graves' hyperthyroidism to Hashimoto's hypothyroidism. Generally, patients with autoimmune thyroid disorders will lean towards one end of the spectrum or the other, with fluctuations between hyper- and hypothyroidism rarely seen. This is especially the case when persistent hyperthyroidism occurs after a prolonged period of hypothyroidism. Here, we present a case of a young female patient initially presenting with Graves' disease with a previous history of hypothyroidism.

Keywords: graves's disease; hashimoto's hypothyroidism; hyperthyroid; hypothyroid; thyroid peroxidase antibodies.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Admission EKG showing sinus tachycardia
Figure 2
Figure 2. Ultrasound of the thyroid and parathyroid showing right and left thyroid lobes along with isthmus
Of note is the heterogeneous thyroid with a nodule on the right as well as left sides (arrows).
Figure 3
Figure 3. TSH trend pointing to gradual transformation from hypothyroid to hyperthyroid state
TSH: thyroid-stimulating hormone
See this image and copyright information in PMC

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