Endocrine Abstracts

Introduction: Graves’ disease is an autoimmune disease of the thyroid that manifests as hyperthyroidism, homogeneous goiter and sometimes ophthalmopathy. Medical treatment with synthetic antithyroid drugs restores clinical and biological euthyroidism. However, an apparently successful treatment can be followed by relapse in 40% of cases. We report the case of a patient who presented with a recurrence of Graves’ disease after 30 years of remission.

Observation : This is a 62-year-old patient, followed for Graves’ disease since the age of 30, treated with carbimazole for 2 years and then obtaining remission with clinical and biological euthyroidism. She presented for consultation for thyrotoxicosis with tachycardia, thermophobia, hand tremors and proptosis. Clinical examination found a homogeneous stage III goiter. The biological evaluation confirms the peripheral hyperthyroidism with a TSH slowed down to 0 mIU/ml and elevated T4L. Thyroid scintigraphy found hyperfixing goiter suggestive of Graves’ disease. The patient received treatment with iodine 131 radiation therapy at a dose of 20 mci. It is then supplemented by LT4 with favorable evolution.

Conclusion : The evolution of Graves’ disease treated medically remains difficult to predict requiring long-term monitoring given the high risk of recurrence even after several years of remission as the case of our patient.