Objective: To highlight conversion of hypothyroidism to hyperthyroidism by case reported and literatures reviewed.
Methods: Case report and literature review.
Results: Two children diagnosed as Hashimotos thyroiditis with hypothyroidism and treated with levothyrocine primary. During the following, hyperthyroidism was noted even the stop the administration of levothyrocine. thyroid receptor antibody (TRAb) was positive during the hyperthyroidism stage and anti-thyroid drugs was administer till now. Literature reviewed showed only 75 cases with conversion of hypothyroidism to hyperthyroidism were reported previously. Among 77 cases, 8 was children and 69 was adults aged from 5.3 to 66 years with a median age of 41.5 years. The duration from hypothyroidism to hyperthyroidism ranged from 0.1 to 18 years with a median of 2 years. The primary disease is autoimmune thyroiditis except one case of congenital hypothyroidism. Among these patients, TRAb and thyroid stimulating antibody (TSAb) have increased tendency while TSH-binding antibody (TBAb) have decreased tendency during the conversion.
Conclusion: Although the conversion from hypothyroidism to hyperthyroidism is a rare condition, more attention should pay to hypothyroidism patients. As the mechanism maybe involve TSAb to TBAb switch, monitoring the TSAb and TBAb in early stage may be helpful for early diagnose and further therapy.
Keywords: Hyperthyroidism, Hypothyroidism, Hashimotos thyroiditis, Graves disease, Hashitoxicosis, TSAb, TBAb
27 - 29 Sep 2018
European Society for Paediatric Endocrinology