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Jo, Koh, Lee, Jung, Shin, Yong, and Chung: A Case of Graves' Disease Coexistent with Pulmonary Sarcoidosis
Case Report
Tuberculosis and Respiratory Diseases

Tuberculosis and Respiratory Diseases 2007; 62(5): 417-420.

Published online: 31 May 2007

DOI: https://doi.org/10.4046/trd.2007.62.5.417

A Case of Graves' Disease Coexistent with Pulmonary Sarcoidosis

Ki Won Jo, M.D., Jang Hyun Koh, M.D., Mi Young Lee, M.D., Feel Moon Jung, M.D., Young Goo Shin, M.D., Suk Joong Yong, M.D., Choon Hee Chung, M.D.

Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea.

Address for correspondence: Suk Joong Yong, M.D. Department of Internal Medicine, Wonju College of Medicine, Yonsei University, 162 Ilsan-dong, Wonju-si, Kangwon-do, 220-701, Korea. Phone: 82-33-741-1232, Fax: 82-33-731-5884, yongsj@yonsei.ac.kr

Received 21 February 2007       Accepted 20 April 2007

Copyright © 2007 The Korean Academy of Tuberculosis and Respiratory Diseases

Abstract

Sarcoidosis is a multisystemic granulomatous disease with an of unknown etiology, involving bilateral hilar lymphadenopathy, pulmonary, skin and eye lesions. However, involvement of the endocrine system in sarcoidosis is quite rare, and the coexistence of both diseases is extremely unusual. We describe a 60-year-old woman presenting with sarcoidosis and Graves' disease. She was admitted for evaluation of dry cough, dyspnea, palpitation and general weakness. Both thyroid glands were enlarged diffusely. The thyroid function tests showed suppressed serum thyrotropin and an increased thyroid hormone level. The levels of the TSH receptor antibody, anti-thyroglobulin antibody and anti-microsomal antibody were higher than normal. The radionuclide scan(131I) showed increased iodine uptake. The chest X-ray revealed pulmonary hilar enlargement and high resolution CT showed both hilar lymph nodes enlargement and tiny parenchymal nodules. The transbronchial lung biopsy showed a noncaseating granuloma without necrosis. We report this case of pulmonary sarcoidosis plus Graves' disease with a review of the relevant literatures.

Keywords: Graves' disease, Sarcoidosis, Hyperthyroidism

Figures and Tables

Figure 1
Chest computed tomography showed bilateral hilar lymphadenopathy (red arrows) and parenchymal tiny nodules.
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Figure 2
Lung biopsy showed noncaseating granulomas with lymphangitic distribution (A: ×100, B: ×400, H&E stain).
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Figure 3
After injection of Tc-99m pertechnetate 5mCi, the increased uptake of radioactivity and diffusely enlarged both lobe of thyroid gland can be seen without any focal photon abnormality (A). The uptake ratios of I-131 at 2hours, 24 hours and the uptake ratio of Tc-99m pertechnetate at 20 minutes are measured 71.37%, 92.91% and 6.22%, respectively (B).
trd-62-417-g003

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