Hyperthyroidism of Graves' disease: Evidence for only unilateral involvement of the thyroid gland in a 31-year-old female patient

Hyperthyroidism of Graves' disease (Morbus Basedow) is known to involve the thyroid gland in tote, unlike Graves' ophthalmopathy which clinically may either be unilateral or bilateral. We report a 31-year-old Caucasian female patient who presented with unilateral goiter and clinical and laboratory e vidence for hyperthyroidism. High-resolution ultrasonography of the thyroid gland revealed a morphology indicative of an autoimmune thyroid disease st rictly limited only to the right lobe. I-123- scintiscanning showed a homog enous but several fold increased uptake of the radionuclide in the right lo be of the thyroid gland, where-as the uptake in the left lobe did not diffe r from the uptake in normal controls. Cytology of the fine needle aspirate of the right lobe revealed a remarkable inflammatory background mainly by p resence of lymphocytes, a finding which was not seen in the cytology of the left lobe. Furthermore, both serum antibodies to TSH-receptors and thyroid peroxidase were significantly increased. Consequently, hyperthyroidism of Graves' disease with the involvement of only one lobe of the thyroid gland was diagnosed. (C) 1999, Editrice Kurtis.