Abstract
In 15-year-old girl with diffuse thyroid enlargement and clinical symptoms of hyperthyroidism total T4 levels and T3 resin uptake were in the range of normal, TSH however was undetectable and total T3 with 5, 6 ng/ml was significantly elevated. TRH and T3 suppression tests indicated an autonomous thyroid function. Thyroid stimulating immunoglobulins examined by radioreceptor method gave higly positive results. The diagnosis was: T3 toxicosis in a patient with Graves' disease. At the age of 15 ½ she started with metizol/methyl-2-mercaptoimidazole/ therapy and after 17 days thyreoidea sicca was added. Serum T4 decreased gradually during 2 months to hypothyroidal levels /6, 8-1, 8-0, 0 /ug/100 ml/but T3, was still elevated /5, 6-2, 2-3, 5 ng/ml respectively/. These observations allow to suppose an excessive peripheral T4 to T3 conversion in our patient.
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