Concomitant association of thyroid sarcoidosis and Graves' disease

Abstract

Objective: Graves' disease (GD) with sarcoid involvement of the thyroid gland has rarely been reported. Method. We report a case of GD with thyroid sarcoidosis in a 28-year-old woman. Thyroid function was assessed by triiodothyronine (T-3), thyroxine (T-4), thyroid-stimulating hormone (TSH) and TSH receptor antibodies (TSH-R Ab). Thyroid scintigraphy, ultrasound and fine-needle aspiration biopsy were performed. The patient underwent surgery. Result. The patient had a nodular goiter. Serum T-3, T-4 and TSH-R Ab levels were elevated with suppressed TSH level. Scintigraphy showed diffuse activity as seen in GD, and ultrasound revealed that parenchyma was heterogenous. Sarcoidosis was discovered on routine chest X-ray. Although no sarcoid involvement was found on specimen, the thyroid gland showed noncaseating granulomas on histology. Conclusion: Since sarcoid involvement of the thyroid gland can cause hypofunction, we report the uncommon infiltration of sarcoidosis with hyperthyroidism. Copyright (C) 2003 S. Karger AG, Basel.