GRAVES-DISEASE FOLLOWING AUTOIMMUNE PRIMA RY HYPOTHYROIDISM - STUDY OF 7 CASES

The evolution of Graves' disease following auto immune hypothyroidism appears to be rather unfrequent. We present seven female patients with autoimmune thyroiditis, 2 with goiter and 5 with hypothyroidism who, after a few months or years, presented signs of Graves'. Therefore it is usefull to carefully monitor TSH in patients treated for autoimmune thyroiditis to detect a possible evolution towards Graves' disease. T his should be mostly true in patients with TBII positive antibodies au toimmune thyroiditis. During hyperthyroidism, 123 iodine uptake is muc h lower than usually observed in Graves', nevertheless, it is always i ncreased compared to the uptake measured during hypothyroidism. This c ould be in favor of residual functionnal capacity of these often small thyroid glands. The alternate action of blocking or stimulating antib odies upon the TSH receptor would probably explained the switch from h ypo to hyperthyroidism, even if there is usually no correlation betwee n antibodies levels and clinical signs.