Painful Goiter: A Rare Presentation of Graves Disease

Abstract

Here we report a rare case of Graves disease presenting as subacute thyroiditis. In the literature, only two reports are available of such a presentation. Various authors have reported in total 33 patients with subacute thyroiditis who were subsequently, between 1 and 18 months later, diagnosed with Graves disease. However, only two patients with both subacute thyroiditis and Graves disease simultaneously have been reported. Subacute thyroiditis is an inflammatory disorder while Graves disease has an autoimmune basis. Although the association of the two could be incidental, it could be postulated that thyroiditis exposes autoantigens, enhancing antibody formation in susceptible patients and thereby precipitating or unmasking Graves disease. Hence, it is important to remember that though rare, Graves disease can present with painful goiter due to concurrent thyroiditis, or rather is unmasked by the inflammation.




J Med Cases. 2014;5(4):217-219
doi: https://doi.org/10.14740/jmc1626w