Y. Hidaka et al., RECURRENCE OF THYROTOXICOSIS AFTER ATTACK OF ALLERGIC RHINITIS IN PATIENTS WITH GRAVES-DISEASE, The Journal of clinical endocrinology and metabolism, 77(6), 1993, pp. 1667-1670
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.