Graves' disease and thyroxine-binding globulin excess

Abstract

Tb the Editor .—We have read with interest the article in the June issue of theArchivesby Dall' Aglio et al 1 on incorrect treatment following the lack of recognition of the association of Graves' disease with thyroxine-binding globulin (TBG) deficiency (TBG-d). The Table summarizes the relevant data of a case of Graves' disease (in a 57-year-old man) associated with the opposite TBG variation, ie, TBG excess (TBG-e), an association not recognized until our observation. Such an association is more frequent than the association with TBG-d. In fact, no thyroid disease was found in 30 subjects with inherited TBG-d, 2 and only five cases of TBG-d were isolated in a series of 250 thyrotoxic patients (2%) 3 ; on the contrary, four patients with Graves' disease were found among 56 subjects (7%) with inherited TBG-e 2 and 11 cases of inherited TBG-e were found among 155 patients (7%) with Graves'