Abstract
The transition of toxic or nodular goiter to Graves’ disease is known as a rare side
effect of 131I therapy. Here, we report the case of a 46-year-old German female with posttherapeutical
Graves’ disease after surgery of a multinodular goiter. Although the major part of
the thyroid was excised the patient suffered from manifest Graves’ disease including
typical clinical and laboratory findings. Prior to surgery, no TSH receptor antibodies
were found, although low TPO antibody titres could already be detected. It may thus
be assumed that the therapeutic manipulation elicited the key change towards a TSH
receptor antibody production in a predisposed organ or alternatively deteriorated
a mild unapparent pre-existing Graves’ disease. It might be concluded that the possibility
of posttherapeutical Graves’ disease should be considered in the presence of TPO antibodies
prior to the surgical intervention.
Key words
Graves’ disease - multinodular goiter - surgery - TPO antibodies
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Correspondence
Dr. med. Dr. phil. A. Heinzel
Clinic for Nuclear Medicine (KME)
Research Centre Juelich
52426 Juelich
Germany
Phone: +49/2461/61 63 21
Fax: +49/2461/61 80 44
Email: a.heinzel@fz-juelich.de
