A case of hypothyroid Graves' disease following external radiation therapy to the cervical region.

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.

• 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)

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