Journal List > J Korean Endocr Soc > v.22(3) > 1003364

TOOLS
Lee, Kim, Lim, Hur, Baek, Kang, Cho, Lee, and Park: A Case of Graves' Disease Associated with Systemic Sclerosis
Case Report
Journal of Korean Endocrine Society

Journal of Korean Endocrine Society 2007; 22(3): 220-224.

Published online: 20 June 2007

DOI: https://doi.org/10.3803/jkes.2007.22.3.220

A Case of Graves' Disease Associated with Systemic Sclerosis

Yune Jeong Lee, Mee Kyoung Kim, Dong Jun Lim, Ki Hoon Hur, Ki Hyun Baek, Moo Il Kang, Chul Soo Cho, Kwang Woo Lee, Gyeong Sin Park1

Department of Internal Medicine, Catholic University, College of Medicine, Korea.

1Department of Clinical Pathology, Catholic University, College of Medicine, Korea.

Received 30 November 2006       Accepted 28 March 2007

Copyright © 2007 Korean Endocrine Society

Abstract

Systemic sclerosis is associated with a broad spectrum of autoimmune thyroid diseases. The association between systemic scleroderma and hypothyroidism is well established. However, there have been very few reports concerning the association between hyperthyroidism and systemic scleroderma. We experienced a patient with Graves' disease who presented with muscle weakness and the patient was finally diagnosed with systemic sclerosis via pathological examination of the muscle. We describe here a rare case of systemic sclerosis associated with Graves' disease.

Keywords: Graves' disease, Systemic sclerosis, Total thyroidectomy

Figures and Tables

Fig. 1
99mTc thyroid scan. 99mTc thyroid scan shows diffuse enlargement of both thyroid gland and uneven uptake of 99mTc. There are multinodular goiter. There are variable sized cold areas in both thyroid lobe.
jkes-22-220-g001
Fig. 2
Histology of thyroid. A, There is nodular Hashimoto's thyroiditis (H&E, ×40); B, There are diffuse hyperplastic follicles of background Graves' disease (H&E, ×100).
jkes-22-220-g002
Fig. 3
Histology of skin biopsy. A, There are hyalinized collagen bundles with atrophic adnexa and perivascular lymphoid infiltration (H&E, ×40); B, There is hyalinized intermysial fibrous tissue (H&E, ×100).
jkes-22-220-g003

References

1. Kucharz EJ. Thyroid disorders in patients with progressive systemic sclerosis: A review. Clin Rheumatol. 1993. 12:159–161.
2. Rake G. On the pathology and pathogenesis of scleroderma. Bull Johns Hopkins Hosp. 1931. 48:212–227.
3. Gordon MB, Klein I, Dekker A, Rodnan GP, Medsger TA Jr. Thyroid disease in progressive systemic sclerosis: Increased frequency of glandular fibrosis and hypothyroidism. Ann Intern Med. 1981. 95:431–435.
4. Biro E, Szekanecz Z, Czirjak L, Danko K, Kiss E, Szabo NA, Szucs G, Zeher M, Bodolay E, Szegedi G, Bako G. Association of systemic and thyroid autoimmune diseases. Clin Rheumatol. 2006. 25:240–245.
5. Shoaleh-var M, Momtaz AH, Jamshidi C. Scleroderma and hyperthyroidism, Report of a case. JAMA. 1976. 235:752–753.
6. Ward JA, Mendeloff J, Coberly JC. Hyperthyroidism followed by scleroderma. JAMA. 1977. 237:1123.
7. Nicholson D, White S, Lipson A, Jacobs RP, Borenstein DG. Progressive systemic sclerosis and Graves' disease. Report of three cases. Arch Inter Med. 1986. 146:2350–2352.
8. Anzai H, Tajima S. Systemic scleroderma Associated with Graves' disease. J Dermatol. 1996. 23:896–898.
9. Yamada T, lizuka K, Yuasa K, Saeki S, Abe T, Sakurai S. A case of chronic hepatits complicated with progressive systemic sclerosis and Graves' disease. Nippon Shokakibyo Gakkai Zasshi. 1985. 82:2850 –2854.
10. Hatakeyama M, Miyagi J, Takeda A, Masuyama J, Sumiya M. A case of progressive systemic sclerosis complicated with polymyositis and Graves' disease. Ryumachi. 1983. 23:155–162.
11. Masuko-Hongo K, Kato T. The association between autoimmune thyroid diseases and rheumatic diseases: a review. Nippon Rinsho. 1999. 57:1873–1877.
12. Park MH, Park YJ, Song EY, Park H, Kim TY, Park DJ, Park KS, Cho BY. Association of HLA-DR and -DQ genes with Graves disease in Koreans. Hum Immunol. 2005. 66:741–747.
13. Joung CI, Jun JB, Chung WT, Song GG, Choe JY, Chang HK, Yoo DH. Association between the HLA-DRB1 gene and clinical features of systemic sclerosis in Korea. Scand J Rheumatol. 2006. 35:39–43.
14. Hong SB, Kim MS, Lee KW, Kim MR, In HH, Kim KR, Cho YU, Joo YC. Graves disease associated with Hashimotos thyroiditis. J Kor Soc Endocrinol. 1996. 11:182–188.
15. Wood LC, Ingbar SH. Hypothyroidism as a late sequela in patient with Graves' disease treated with antithyroid agents. J Clin Invest. 1979. 64:1429–1436.
TOOLS
Similar articles