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KMID : 0356620080230050337
Journal of Korean Society of Endocrinology
2008 Volume.23 No. 5 p.337 ~ p.341
A Case of Painful Graves` Disease
Jeong Ji-Yun

Kim Tae-Yong
Kim Eun-Hee
Kim Eui-Young
Lee Sang-Ah
Yim Ji-Hye
Kim Kyung-Min
Kim Won-Bae
Shong Young-Kee
Abstract
Graves` disease rarely presents as pain and tenderness of goiter, with only a few cases reported in the literature. We describe a case of painful Graves` disease presenting as 2 episodes of painful goiter. A-25-yr-old male was referred to our hospital because of pain in the anterior neck, palpitations, and muscle weakness. His heart rate was 122 beat/min and body temperature was normal. The thyroid gland was enlarged and tender. His thyroid function test showed thyrotoxicosis with high TSH binding inhibitory immunoglobulin (TBII) and thyroid peroxidase antibody (TPO Ab). A 99mTc-pertechnate thyroid scan showed diffuse increased uptake with no focal defects. He was started on propranolol, methimazole, Lugol`s solution, and prednisolone. He was discharged 7 days later with improved painful symptoms. The prednisolone was tapered out for 2 months. Eight months after the initial pain, he experienced one more episode of thyroid pain and hyperthyroidism, with an increase in TBII. He was treated with methimazole and prednisolone, and responded well.
KEYWORD
Graves` disease, painful goiter, painful Hashimoto`s thyroiditis
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