Two Cases-Report of Mild Graves?Disease Following Subacute Thyroiditis: More Evidence of the Role of Thyroglobulin in The Pathogenesis of Autoimmune Thyroid Disease?

Michalaki M Koukkou Eftychia

doi:10.4172/2167-7948.1000184

Abstract

Two middle aged Caucasian women with no previous history of thyroid or any other disease developed typical subacute thyroiditis (SAT) with minimal thyroidal radioactive iodine uptake. A few months after restoration of euthyroidism and discontinuation of corticosteroid therapy, they developed mild hyperthyroidism due to Graves’ disease (GD), as judged by the increased diffuse thyroidal radioactive iodine uptake. Both of them were genetically predisposed to the above diseases since they had the certain HLA haplotypes for SAT and GD. Also they developed anti- thyroglobulin antibodies during the period of GD. We hypothesize that genetic background and the increased load of Tg or other autoantigens released from the distracted damaged thyroid gland due to SAT triggered the development of GD a few months later.

Highlights

Subacute thyroiditis (SAT) is an inflammatory disorder of the thyroid gland that is thought to be of viral origin [1]
We have described two rare cases where SAT was followed within a few months by Graves disease (GD) in two Caucasian women
It is well known that SAT is a non-autoimmune disease, but it is a self-limited inflammatory disorder of viral origin in genetically predisposed individuals [4]