Abstract 117: Uncommon presentation of a common disease

Abstract

Background: Autoimmune thyroid disorders, particularly Graves’ disease presenting as generalized pruritus is uncommon.Case Report: This is a case report of 42 y old male driver presented with generalized pruritus at the primary care clinic. His symptoms didn’t resolve on taking antihistamines. The patient was referred to higher center. Pruritus was not associated with any food or fabric allergy, no past history of bronchial asthma, eczema, renal or hepatic disease. On examination, he is not looking jaundiced or pale. Apart from superficial scratch marks on his trunk and all 4 limbs, there were neither skin eruptions, burrows, vesicles, nor scaly lesions to suggest scabies orfungal infection. Incidental findings of tachycardia and a goiter led to the investigations of his thyroid status. There was no exophthalmos, organomegaly or dermopathy. General laboratory investigations were performed and elevated total T4 and suppressed TSH hormone values were found in his thyroid function tests. Tc 99 thyroid scintigraphy showed diffuse increased uptake. He was diagnosed with Graves’ disease and treated with carbimazole. His itching subsided on follow up.Conclusion: A thorough and complete physical examination is of paramount importance in making an accurate diagnosis.