Endocrine journal · 2006
A case of hypothyroid Graves' disease following external radiation therapy to the cervical region.
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Nishihara Eijun, Fukata Shuji, Kimura Nobuhiko, Hagihara Masahiro, Kudo Takumi, Ohye Hidemi, Ito Mitsuru, Kubota Sumihisa, Amino Nobuyuki, Kuma Kanji, Miyauchi Akira
Аннотация
A case of hypothyroid Graves' disease occurred following external radiation therapy to the cervical region is described. Severe hypothyroidism developed in a 56-year-old man 6 months after external radiation therapy for submandibular cancer. Serological evaluation of thyroid autoimmunity revealed the presence of antithyroid antibodies and thyrotropin-binding inhibitory immunogloblins (TBII). Diplopia, limitation of downward gaze, and palpebral edema developed 2 years after levothyroxine replacement therapy. Ocular magnetic resonance imaging revealed marked hypertrophy of the bilateral extraocular muscles with signal hyperintensity on T2-weighted images. This infiltrative ophthalmopathy showed marked improvement after additional treatment with high-dose methylprednisolone and orbital radiation, in parallel with a decrease in TBII. These results suggest that radiation-associated thyroidal injury might be associated with the etiology of hypothyroid Graves' disease.