Autoimmune thyroid disease--a continuous spectrum.

AIM: to present a case report revealing a variant of natural history of autoimmune thyroid disease.

CASE REPORT: I.F., a 39 years old woman, had a previous medical history of Graves' disease treated with antithyroid drugs (ATD). After 1 year of treatment, the remission was confirmed one and two years after ATD withdrawal. Twenty years after the initial hyperthyroidism, spontaneous subclinical hypothyroidism was diagnosed. The patient presented both anti TSH-receptor (TSH-R) antibodies (Ab), antithyroperoxidase (TPO) and antithyroglobulin (antiTgl) antibodies in elevated titres.

CONCLUSION

Because of the shift from hyperthyroidism to euthyroidism or to spontaneous hypothyroidism, Graves' disease patients demand a strict follow-up after ATD therapy. It seems that there is an effect of TPOAb on thyroid destruction.