A case of Graves' disease developing with exacerbation of sarcoidosis.
Graves’ disease
eosinophil
sarcoidosis
Journal
Sarcoidosis, vasculitis, and diffuse lung diseases : official journal of WASOG
ISSN: 2532-179X
Titre abrégé: Sarcoidosis Vasc Diffuse Lung Dis
Pays: Italy
ID NLM: 9610928
Informations de publication
Date de publication:
2019
2019
Historique:
received:
19
03
2019
accepted:
30
10
2019
entrez:
2
6
2020
pubmed:
1
1
2019
medline:
25
8
2020
Statut:
ppublish
Résumé
A 53-year old female was referred to our hospital with bilateral abnormal shadow in the chest X-ray. Computed tomography revealed multifocal ill-defined densities and thickening of bronchial wall and pulmonary vessels by fine nodules combined with massive enlargement of bilateral mediastinal and hilar lymph nodes. Analyses of bronchoalveolar lavage fluid and transbronchial lung biopsy specimen showed the increase in CD4/CD8 ratio and the presence of non-caseating granulomas, respectively. In addition, serum angiotensin-converting enzyme was extremely high, leading to the diagnosis of sarcoidosis. Simultaneously, she complained of palpitation and sweating. Endocrinological examination showed comorbid hyperthyroidism without anti-TSH receptor antibody (TRAb). In the first 2-3 months, pulmonary shadow gradually disappeared without steroid administration. In parallel, serum thyroid hormone levels were gradually normalized in the beginning, but increased after 3 months with an appearance of TRAb. After initiation of treatment with antithyroid agent, hyperthyroidism was improved within 9 months, and changed into hypothyroidism thereafter. The clinical course of this rare case suggest that immunological storm by exacerbation of sarcoidosis may trigger the onset of autoimmune thyroid disease, in which hyperthyroidism with stimulating type of TRAb subsequently changed into hypothyroidism with blocking-type TRAb.
Identifiants
pubmed: 32476968
doi: 10.36141/svdld.v36i4.8307
pii: SVDLD-36-318
pmc: PMC7247091
doi:
Substances chimiques
Antithyroid Agents
0
Biomarkers
0
Immunoglobulins, Thyroid-Stimulating
0
thyroid stimulation-blocking antibody
0
thyrotropin-binding inhibitory immunoglobulin
0
Types de publication
Case Reports
Langues
eng
Pagination
318-324Informations de copyright
Copyright: © 2019.
Références
Clin Rev Allergy Immunol. 2015 Aug;49(1):6-18
pubmed: 25771769
Tohoku J Exp Med. 1985 May;146(1):33-45
pubmed: 4024082
Indian J Endocrinol Metab. 2013 Mar;17(2):332-5
pubmed: 23776915
Thorax. 1981 Apr;36(4):296-8
pubmed: 7281099
Thorax. 1984 Jan;39(1):19-22
pubmed: 6582657
Reumatol Clin. 2016 Jul-Aug;12(4):235-6
pubmed: 26702509
Horm Res. 2003;59(1):43-6
pubmed: 12566735
Eur Respir J. 1995 Feb;8(2):327-30
pubmed: 7758571
Eur J Endocrinol. 1996 Mar;134(3):331-6
pubmed: 8616531
Thyroid Res. 2015 Apr 11;8:5
pubmed: 25908941
Eur Respir J. 2003 Mar;21(3):407-13
pubmed: 12661993
Mayo Clin Proc. 2000 Jun;75(6):586-90
pubmed: 10852419
Sarcoidosis Vasc Diffuse Lung Dis. 2007 Sep;24(2):148-52
pubmed: 18496986
Endocr Pract. 2007 Mar-Apr;13(2):159-63
pubmed: 17490930
Croat Med J. 1998 Dec;39(4):404-6
pubmed: 9841940
Am J Med. 1988 Sep;85(3):418-20
pubmed: 2901227
Thyroid. 2003 Aug;13(8):811-4
pubmed: 14558923
Thyroid. 2000 Mar;10(3):275-8
pubmed: 10779143
Respir Med Case Rep. 2013 Feb 16;8:43-6
pubmed: 26029615
Hormones (Athens). 2012 Oct-Dec;11(4):436-43
pubmed: 23422766
J Dermatol. 2017 Apr;44(4):423-430
pubmed: 27786368
Int Arch Allergy Immunol. 2003 Nov;132(3):268-76
pubmed: 14646389
Front Endocrinol (Lausanne). 2017 Aug 08;8:177
pubmed: 28848497
Nihon Kyobu Shikkan Gakkai Zasshi. 1989 Jan;27(1):98-106
pubmed: 2747065
Proc Am Thorac Soc. 2007 Aug 15;4(5):461-4
pubmed: 17684290
Endocr Rev. 2003 Oct;24(5):694-717
pubmed: 14570752
Curr Opin Pulm Med. 2002 Sep;8(5):452-6
pubmed: 12172452
Chest. 1993 Aug;104(2):352-61
pubmed: 8339618
Clin Endocrinol (Oxf). 1997 Apr;46(4):467-72
pubmed: 9196610
Clin Exp Immunol. 2008 Apr;152(1):127-37
pubmed: 18279440
Jpn J Med. 1991 Mar-Apr;30(2):113-7
pubmed: 1678021
Eur Respir J. 2006 Mar;27(3):451-9
pubmed: 16507843
Ann Am Thorac Soc. 2017 Dec;14(Supplement_6):S429-S436
pubmed: 29073364
Thyroid. 1999 Jul;9(7):705-13
pubmed: 10447018
J Med Invest. 1998 Aug;45(1-4):131-6
pubmed: 9864974
Chest. 2006 Aug;130(2):526-32
pubmed: 16899854
J Am Acad Dermatol. 2012 Jan;66(1):167-8
pubmed: 22177644
J Clin Invest. 1981 Jan;67(1):86-92
pubmed: 6969734
J Thorac Dis. 2017 Jan;9(1):88-95
pubmed: 28203410
Clin Endocrinol (Oxf). 2003 Apr;58(4):403-8
pubmed: 12641621
J Endocrinol Invest. 2006 Oct;29(9):834-9
pubmed: 17114917
J Clin Endocrinol Metab. 1989 Jul;69(1):49-53
pubmed: 2471711