RECURRENCE OF THYROTOXICOSIS AFTER ATTACK OF ALLERGIC RHINITIS IN PATIENTS WITH GRAVES-DISEASE

Graves' disease is frequently aggravated during antithyroid drug thera py; however, little is known of its aggravating factors. We studied 83 patients with Graves' disease who were euthyroid for at least 6 month s under antithyroid maintenance therapy, and we examined the relations hip between thyrotoxicosis relapse, attack of allergic rhinitis, and p eripheral eosinophil increase. Forty-one patients showed thyrotoxicosi s relapse; of these, 22 (54%) showed peripheral eosinophil increase, a nd 14 (34%) had attacks of allergic rhinitis. In the remaining 42 pati ents without thyrotoxicosis relapse, only 4 (10%, P < 0.001) showed an increase in peripheral eosinophils, and only 3 (7%, P < 0.01) had all ergic rhinitis. Recurrence of thyrotoxicosis was observed with the inc rease in serum levels of TSH-receptor antibodies and increase in eosin ophils 2 months after the attack of allergic rhinitis. Three patients with seasonal allergic rhinitis showed thyrotoxicosis relapse at the s ame time of year within 2 consecutive years. Our findings indicate tha t allergic rhinitis can be an aggravating factor of Graves' disease an d suggest that the preceding increase in peripheral eosinophils can be a predictive indicator of recurrence of thyrotoxicosis during antithy roid drug therapy.