A Case of Recurrence of Graves Disease and Adenomatous Goiter Accompanied by Diabetes Mellitus

Simultaneous occurrences of diabetic ketoacidosis (DKA) and thyroid storm have long been known, but only a few cases have been reported to date. Both these endocrine emergencies demand timely diagnosis and management to prevent adverse outcomes. Due to the similarities in their clinical presentation, DKA can mask the diagnosis of thyroid storm and vice versa. This case report describes a patient with Graves’ disease who presented to the emergency department with nausea, vomiting and abdominal pain. He was found to have severe DKA without an explicit history of diabetes mellitus. Further evaluation revealed that the patient also had a concomitant thyroid storm that was the likely cause of his DKA. Early recognition and appropriate management of both conditions resulted in a favourable outcome. This paper emphasises that a simultaneous thyroid storm diagnosis should be considered in patients with DKA, especially those with a known history of thyroid disorders.

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Graves' Disease and Diabetes Mellitus

Paediatrica Indonesiana ◽

10.14238/pi32.11-12.1992.327-31 ◽

2019 ◽

Vol 32 (11-12) ◽

pp. 327-31

Author(s):

M. Suttan Assin ◽

Jusuf Rukman ◽

Jose R. L. Batubara ◽

Purnama Wati S. P.

Keyword(s):

Diabetes Mellitus ◽

Thyroid Hormones ◽

Graves Disease ◽

Hyperthyroid Patient ◽

Hyperthyroid State

Thyroid hormones play an important role in the metabolic propesses. Its disturbances will involve several organs, consequently. A 5 year old girl with Graves' diseases, after several weeks of treatment with propylthiouracil (PTV), developed thyrotoxicosis crisis and diabetes mellitus with ketoacidosis; a condition which is usually fatal. Treatment toward the hyperthyroid state overcome the diabetic stage, eventually. This report is an example of an endocrinological interaction in a hyperthyroid patient. Therefore, the diabetogenic effect of hyperthyroxinemia should not be overlooked.

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LETTER TO THE EDITOR: LACK OF EFFECT OF PARAHYDROXYPROPIOPHENONE IN HYPEROPHTHALMOPATHIC GRAVES' DISEASE AND DIABETES MELLITUS

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jcem-12-5-604 ◽

1952 ◽

Vol 12 (5) ◽

pp. 604-606 ◽

Cited By ~ 2

Author(s):

ROSCOE O. BRADY ◽

THOMAS HEDGES

Keyword(s):

Diabetes Mellitus ◽

Graves Disease ◽

Letter To The Editor

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Insulin-dependent diabetes mellitus associated with Graves’ disease and idiopathic hypoparathyroidism

Journal of Endocrinological Investigation ◽

10.1007/bf03347687 ◽

1993 ◽

Vol 16 (8) ◽

pp. 643-646 ◽

Cited By ~ 6

Author(s):

Keiji Yoshioka ◽

A. Ohsawa ◽

T. Yoshida ◽

S. Yokoh

Keyword(s):

Diabetes Mellitus ◽

Insulin Dependent Diabetes Mellitus ◽

Insulin Dependent Diabetes ◽

Dependent Diabetes Mellitus ◽

Graves Disease ◽

Insulin Dependent

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Graves’ disease in subjects with type 1 diabetes mellitus: A prevalence study in western Sicily (Italy)

Primary Care Diabetes ◽

10.1016/j.pcd.2011.06.001 ◽

2011 ◽

Vol 5 (4) ◽

pp. 241-244 ◽

Cited By ~ 5

Author(s):

Domenico Greco ◽

Maria Pisciotta ◽

Francesco Gambina ◽

Filippo Maggio.

Keyword(s):

Diabetes Mellitus ◽

Type 1 Diabetes ◽

Type 1 Diabetes Mellitus ◽

Prevalence Study ◽

Graves Disease ◽

Western Sicily

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Properdin factor B (Bf) and glyoxalase in Graves' disease

Acta Endocrinologica ◽

10.1530/acta.0.1020057 ◽

1983 ◽

Vol 102 (1) ◽

pp. 57-61 ◽

Cited By ~ 2

Author(s):

H. Allannic ◽

R. Fauchet ◽

Y. Lorcy ◽

H. Phengsavath ◽

M. Gueguen ◽

...

Keyword(s):

Diabetes Mellitus ◽

Linkage Disequilibrium ◽

Insulin Dependent Diabetes Mellitus ◽

Dependent Diabetes Mellitus ◽

Graves Disease ◽

Frequency Data ◽

Factor B ◽

Insulin Dependent ◽

The Difference ◽

Properdin Factor B

Abstract. Patients with Graves' disease were phenotyped for properdin factor B (Bf) and glyoxalase, which are coded for by genes mapping close to the HLA region on the sixth chromosome. Frequency data were analysed in relation to HLA-A, -B and -DR typing data. Diagnosis of Graves' disease was based on the usual criteria including elevated T3 and T4 levels and free T4 index and a homogenous thyroid scan. Ninety-four patients with Graves' disease were phenotyped for properdin factor B (Bf) and 37 for red cells glyoxalase (GLO). HLA-A, -B and -DR antigens were typed in 94 patients using a lymphocyte microcytotoxicity assay. The frequency distribution of Bf and GLO alleles showed no significant differences from control subjects. This finding contrasts with the reports of an increased frequency of Bf Fl in insulin-dependent diabetes mellitus. The difference in the two diseases which are both associated with an increased frequency of the antigen combination D8-DR3, is accounted for by linkage disequilibrium between B 18 and BfF1.

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