Abstract |
A case of hypothyroid Graves' disease occurred following external radiation therapy to the cervical region is described. Severe hypothyroidism developed in a 56-year-old man 6 months after external radiation therapy for submandibular cancer. Serological evaluation of thyroid autoimmunity revealed the presence of antithyroid antibodies and thyrotropin-binding inhibitory immunogloblins (TBII). Diplopia, limitation of downward gaze, and palpebral edema developed 2 years after levothyroxine replacement therapy. Ocular magnetic resonance imaging revealed marked hypertrophy of the bilateral extraocular muscles with signal hyperintensity on T2-weighted images. This infiltrative ophthalmopathy showed marked improvement after additional treatment with high-dose methylprednisolone and orbital radiation, in parallel with a decrease in TBII. These results suggest that radiation-associated thyroidal injury might be associated with the etiology of hypothyroid Graves' disease.
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Authors | Eijun Nishihara, Shuji Fukata, Nobuhiko Kimura, Masahiro Hagihara, Takumi Kudo, Hidemi Ohye, Mitsuru Ito, Sumihisa Kubota, Nobuyuki Amino, Kanji Kuma, Akira Miyauchi |
Journal | Endocrine journal
(Endocr J)
Vol. 53
Issue 3
Pg. 357-61
(Jun 2006)
ISSN: 0918-8959 [Print] Japan |
PMID | 16714839
(Publication Type: Case Reports, Journal Article)
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Topics |
- Carcinoma, Squamous Cell
(radiotherapy)
- Diplopia
(diagnostic imaging, etiology)
- Graves Disease
(diagnosis, etiology)
- Graves Ophthalmopathy
(etiology)
- Humans
- Hypothyroidism
(diagnosis, etiology)
- Male
- Middle Aged
- Radiation Injuries
(etiology)
- Radiotherapy
(adverse effects)
- Submandibular Gland Neoplasms
(radiotherapy)
- Ultrasonography
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