Asymmetrical Graves' disease in children: potential usefulness of potassium iodide monotherapy.

Abstract

A male junior high school student presented with failure to gain weight and acceleration of growth for 2 years. Free triiodothyronine and free thyroxine levels were elevated, and the thyroid-stimulating hormone (TSH) level was suppressed. TSH receptor antibody (TRAb) and thyroid-stimulating antibody were negative. On I-123 thyroid scintigraphy, iodine uptake was most pronounced in the upper pole of the right lobe. The patient was initially diagnosed with asymmetrical TRAb-negative Graves' disease (GD). His thyroid hormone level normalised with potassium iodide (KI) alone, and he became TRAb-positive 4 months after the initiation of KI therapy. This case demonstrates a rare presentation of GD that was initially TRAb-negative, which had asymmetrical iodine uptake on a thyroid scan and was confirmed to be TRAb positivity during the follow-up. KI monotherapy could be one of the effective treatment options for GD that is initially TRAb-negative.

• Authors: Kyoko Fukahori, Kentaro Sawano, Hiroshi Yoshida, Keisuke Nagasaki
• Journal: BMJ case reports (BMJ Case Rep) Vol. 15 Issue 4 (Apr 22 2022) ISSN: 1757-790X [Electronic] England
• PMID: 35459658 (Publication Type: Case Reports, Journal Article)
• Copyright: © BMJ Publishing Group Limited 2022. No commercial re-use. See rights and permissions. Published by BMJ.

Chemical References

• Autoantibodies
• Immunoglobulins, Thyroid-Stimulating
• Potassium Iodide

Topics

• Autoantibodies
• Child
• Graves Disease (diagnosis, drug therapy)
• Humans
• Immunoglobulins, Thyroid-Stimulating
• Male
• Potassium Iodide (therapeutic use)
• Thyroid Function Tests
• Tomography, X-Ray Computed