Basedow's disease and chronic ulcerative colitis: A case report and reviewof the Japanese literature

A case of Basedow's disease, that developed after successful treatment of u lcerative colitis with a total colectomy, is presented, along with a review of the Japanese literature on the coexistence of hyperthyroidism and ulcer ative colitis, A 26-year-old man was referred to our department, complainin g of general fatigue, appetite loss, and palpitation. At age 14, blood was discovered in his stool and a diagnosis of ulcerative colitis was made. Sin ce then, he has been treated with salazosulfapyridine and prednisolone. On examination, mild exophthalmos and thyroid swelling were observed. Both ser um free T-3 and T-4 levels were increased along with a positive TSH recepto r antibody, while TSH was decreased. Scintigraphic and ultrasonographic exa minations of the thyroid gland showed diffuse enlargement. Treatment with t hiamazole relieved the symptoms and normalized the thyroid function. Althou gh a high incidence of autoimmune thyroid diseases in association with ulce rative colitis has been suggested, only 6 cases of hyperthyroidism coexisti ng with ulcerative colitis have been reported in Japan. A common immunologi cal process has been suggested to be implicated in the pathogenesis of this association, however, the exact mechanism remains unclear.