Difficult-to-Treat Hyperthyroidism

Gan, EH; Pearce, SHS

doi:10.1007/978-1-4471-2789-5

Difficult-to-Treat Hyperthyroidism

Lookup NU author(s): Dr Earn Gan, Professor Simon Pearce ORCiD

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Abstract

© Springer-Verlag London 2015. All rights reserved. This case illustrates a 31-year-old female who presented with thyrotoxicosis and mild thyroid eye disease. Questions relating to this common thyroid condition are addressed in a systematic fashion, including a summary of the clinical signs and symptoms, the appropriate biochemical and radiological investigations, management and follow-up. This case nicely demonstrates the spectrum and heterogeneity of hyperthyroidism in terms of disease severity and response to medication. Although most patients respond well to anti-thyroid drugs, this patient was refractory to this treatment, as shown by her growing goitre and worsening biochemical results despite high dosages of carbimazole. Her condition was eventually treated with total thyroidectomy. The management options for more aggressive Graves’ disease are discussed along with other questions about the case study.