Graves' Disease Coexisting with Probable Autoimmune Hypoparathyroidism

Abstract

Organ-specific autoimmune endocrine disorders may present as single diseases or may occur together in polyendocrine syndromes. We present a report of 23-year-old female with Graves' disease and concurrent hypocalcemia. As she lacked other specific features of autoimmune polyendocrine syndromes, the most likely diagnosis was Graves' disease coexisting with autoimmune hypoparathyroidism.

Key words

Graves' disease - hypoparathyroidism - autoimmune

References

• 1 Chen Q Y, Kukreja A, Maclaren N K. The autoimmune polyglandular syndromes. DeGroot LJ, Jameson JL Endocrinology. 4th ed. Philadelphia; WB Saunders Company 2001: 587-599
• 2 Li Y, Song Y H, Rais N, Connor E, Schatz D, Muir A, Maclaren N. Autoantibodies to the extracellular domain of the calcium sensing receptor in patients with acquired hypoparathyroidism.  J Clin Invest. 1996;  97 910-914
• 3 Miki K, Takamatsu J, Isaji H, Kitazawa A, Nakata K. Idiopathic hypoparathyroidism associated with Graves' disease.  Horumon To Rinsho. 1983;  31 1103-1106
• 4 Ohtsuka Y, Aida A, Shimada M, Murakami K, Kondo T, Ide H, Kawakami Y. Idiopathic hypoparathyroidism associated with hyperthyroidism.  Nippon Naika Gakkai Zasshi. 1988;  77 520-523
• 5 Perheentupa J. APS-I/APECED: the clinical disease and therapy.  Endocrinol Metab Clin North Am. 2002;  31 295-320
• 6 Perheentupa J. Autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy (APEDEC). Eriksson AW, Forsius HR, Nevanlinna HR, Norio R Population Structure and Genetic Disorders. London; Academic Press 1980: 583-588
• 7 Peterson P, Krohn K J. Mapping of B cell epitopes on steroid 17 alpha-hydroxylase, an autoantigen in autoimmune polyglandular syndrome type I.  Clin Exp Immunol. 1994;  98 104-109
• 8 Yamaji Y, Hayashi M, Suzuki Y, Noya K, Yamamoto O. Thyroid crisis associated with severe hypocalcemia.  Jpn J Med. 1991;  30 179-181
• 9 Yoshioka K, Ohsawa A, Yoshida T, Yokoh S. Insulin-dependent diabetes mellitus associated with Graves' disease and idiopathic hypoparathyroidism.  J Endocrinol Invest. 1993;  16 643-646