Abstract
Figures and Tables
Fig. 1
Thyroid ultrasonography showed mild enlargement of both thyroid lobes with heterogenous echogenicity (A) and increased vascularity (B).
![enm-30-620-g001](/upload/SynapseData/ArticleImage/2008enm/enm-30-620-g001.jpg)
Fig. 2
Free thyroxine (FT4), total triiodothyronine (T3), and thyroid stimulating hormone (TSH) levels during treatment. The dark gray area in the figure indicates the duration of cholestyramine use until total thyroidectomy. CA, cholestyramine; PTU, propylthiouracil; MMI, methimazole; KI, potassium iodide; PPL, propranolol; HD, hospital day.
![enm-30-620-g002](/upload/SynapseData/ArticleImage/2008enm/enm-30-620-g002.jpg)
Fig. 3
The postoperative pathology specimens showed right dominant diffuse goiter and no definite nodule was identified; Right thyroid gland was 7.8×4.4×2.2 cm in size and 28.7 g, left thyroid was 6.0×2.4×1.5 cm and 20.6 g, respectively. The final histologic finding was diffuse hyperplasia, consistent with Graves' disease.
![enm-30-620-g003](/upload/SynapseData/ArticleImage/2008enm/enm-30-620-g003.jpg)
Table 1
Laboratory Results Change with Drug Challenges before Admission
![enm-30-620-i001](/upload/SynapseData/ArticleImage/2008enm/enm-30-620-i001.jpg)
We started methimazole (MMI) 30 mg/day and propranolol 30 mg/day as initial dose (month 1). Because laboratory data and symptoms suggested the disease was getting worse, doses of MMI and propranolol were gradually increased up to 45 and 120 mg/day, respectively, till 5th month. Subsequently, AST/ALT levels were increased from 28/31 to 60/81 IU/L. After one month treatment, AST/ALT levels were more increased up to 58/101 IU/L so MMI was changed to propylthiouracil 300 mg/day. However, there was no improvement in thyrotoxicosis.
T3, triiodothyronine; FT4, free thyroxine; TSH, thyroid stimulating hormone; TRAb, TSH receptor antibody; NA, not available; AST, aspartate aminotransferase; ALT, alanine aminotransferase.