Atypical Complications of Graves’ Disease: A Case Report and Literature Review
Joint Authors
Jayyousi, Amin
Siddique, Mashhood Ahmed
Arroub, Shaimaa Ahmed
Ebrahim, Ahmed Hamdi
Baagar, Khaled
Source
Issue
Vol. 2017, Issue 2017 (31 Dec. 2017), pp.1-6, 6 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2017-02-28
Country of Publication
Egypt
No. of Pages
6
Main Subjects
Abstract EN
Graves’ disease (GD) may display uncommon manifestations.
We report a patient with rare complications of GD and present a comprehensive literature review.
A 35-year-old woman presented with a two-week history of dyspnea, palpitations, and edema.
She had a raised jugular venous pressure, goiter, and exophthalmos.
Laboratory tests showed pancytopenia, a raised alkaline phosphatase level, hyperbilirubinemia (mainly direct bilirubin), and hyperthyroidism [TSH: <0.01 mIU/L (reference values: 0.45–4.5), fT4: 54.69 pmol/L (reference values: 9.0–20.0), and fT3: >46.08 pmol/L (reference values: 2.6–5.7)].
Her thyroid uptake scan indicated GD.
Echocardiography showed a high right ventricular systolic pressure: 60.16 mmHg.
Lugol’s iodine, propranolol, cholestyramine, and dexamethasone were initiated.
Hematologic investigations uncovered no reason for the pancytopenia; therefore, carbimazole was started.
Workup for hepatic impairment and pulmonary hypertension (PH) was negative.
The patient became euthyroid after 3 months.
Leukocyte and platelet counts and bilirubin levels normalized, and her hemoglobin and alkaline phosphatase levels and right ventricular systolic pressure (52.64 mmHg) improved.
This is the first reported single case of GD with the following three rare manifestations: pancytopenia, cholestatic liver injury, and PH with right-sided heart failure.
With antithyroid drugs treatment, pancytopenia should resolve with euthyroidism, but PH and liver injury may take several months to resolve.
American Psychological Association (APA)
Baagar, Khaled& Siddique, Mashhood Ahmed& Arroub, Shaimaa Ahmed& Ebrahim, Ahmed Hamdi& Jayyousi, Amin. 2017. Atypical Complications of Graves’ Disease: A Case Report and Literature Review. Case Reports in Endocrinology،Vol. 2017, no. 2017, pp.1-6.
https://search.emarefa.net/detail/BIM-1145125
Modern Language Association (MLA)
Baagar, Khaled…[et al.]. Atypical Complications of Graves’ Disease: A Case Report and Literature Review. Case Reports in Endocrinology No. 2017 (2017), pp.1-6.
https://search.emarefa.net/detail/BIM-1145125
American Medical Association (AMA)
Baagar, Khaled& Siddique, Mashhood Ahmed& Arroub, Shaimaa Ahmed& Ebrahim, Ahmed Hamdi& Jayyousi, Amin. Atypical Complications of Graves’ Disease: A Case Report and Literature Review. Case Reports in Endocrinology. 2017. Vol. 2017, no. 2017, pp.1-6.
https://search.emarefa.net/detail/BIM-1145125
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-1145125