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Graves' disease in monozygotic twins - a case report.

Rüst CA, Knechtle B, Rosemann T - BMC Endocr Disord (2013)

Bottom Line: We present monozygotic female twins developing consecutively Graves' disease within five years.Both the mother and the twins were cigarette smokers.The twins were treated with carbamizole and this therapy led to normalization of thyroid stimulating hormone and thyroxine.

View Article: PubMed Central - HTML - PubMed

Affiliation: Institute of General Practice and Health Services Research, University of Zurich, Zurich, Switzerland. beat.knechtle@hispeed.ch.

ABSTRACT

Background: Autoimmune thyroid diseases including Graves' disease and Hashimoto's thyroiditis are caused by immune response to self-thyroid antigens. The rare situation of hyperthyroidism with Graves' disease in twins has been reported in a very few case reports in literature.

Case presentation: We present monozygotic female twins developing consecutively Graves' disease within five years. One year before the diagnosis of Graves' disease was established in the first twin, the mother developed a toxic thyroid nodule with hyperthyroidism leading to hemi thyroidectomy. Both the mother and the twins were cigarette smokers. The twins were treated with carbamizole and this therapy led to normalization of thyroid stimulating hormone and thyroxine.

Conclusion: This case report supports the hypothesis that a genetic factor as well as an environmental factor (cigarette smoking) might be of great importance in the aetiology of Graves' disease.

No MeSH data available.


Related in: MedlinePlus

Timeline of TSH and fT4 for twin A.
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Figure 1: Timeline of TSH and fT4 for twin A.

Mentions: fT4 (thyroxine) (Figure 1). However, the compliance of carbamizole intake was weak and the dosage of carbamizole had to be changed several times. During drug therapy, the swelling of the neck became reduced. Due to further normalization of the laboratory results, the medication with carbamizole was stopped in autumn 2008. TSH and fT4 were measured later in irregular intervals due to mal-compliance of the patient. In the case history of twin A, tonsillectomy was performed in 1987, a pneumothorax in 2006 was treated conservatively, in 2007 she underwent hallux valgus correction and in 2008 varicose vein stripping. She started smoking cigarettes as a teenager and smokes 5–6 cigarettes a day.


Graves' disease in monozygotic twins - a case report.

Rüst CA, Knechtle B, Rosemann T - BMC Endocr Disord (2013)

Timeline of TSH and fT4 for twin A.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3672004&req=5

Figure 1: Timeline of TSH and fT4 for twin A.
Mentions: fT4 (thyroxine) (Figure 1). However, the compliance of carbamizole intake was weak and the dosage of carbamizole had to be changed several times. During drug therapy, the swelling of the neck became reduced. Due to further normalization of the laboratory results, the medication with carbamizole was stopped in autumn 2008. TSH and fT4 were measured later in irregular intervals due to mal-compliance of the patient. In the case history of twin A, tonsillectomy was performed in 1987, a pneumothorax in 2006 was treated conservatively, in 2007 she underwent hallux valgus correction and in 2008 varicose vein stripping. She started smoking cigarettes as a teenager and smokes 5–6 cigarettes a day.

Bottom Line: We present monozygotic female twins developing consecutively Graves' disease within five years.Both the mother and the twins were cigarette smokers.The twins were treated with carbamizole and this therapy led to normalization of thyroid stimulating hormone and thyroxine.

View Article: PubMed Central - HTML - PubMed

Affiliation: Institute of General Practice and Health Services Research, University of Zurich, Zurich, Switzerland. beat.knechtle@hispeed.ch.

ABSTRACT

Background: Autoimmune thyroid diseases including Graves' disease and Hashimoto's thyroiditis are caused by immune response to self-thyroid antigens. The rare situation of hyperthyroidism with Graves' disease in twins has been reported in a very few case reports in literature.

Case presentation: We present monozygotic female twins developing consecutively Graves' disease within five years. One year before the diagnosis of Graves' disease was established in the first twin, the mother developed a toxic thyroid nodule with hyperthyroidism leading to hemi thyroidectomy. Both the mother and the twins were cigarette smokers. The twins were treated with carbamizole and this therapy led to normalization of thyroid stimulating hormone and thyroxine.

Conclusion: This case report supports the hypothesis that a genetic factor as well as an environmental factor (cigarette smoking) might be of great importance in the aetiology of Graves' disease.

No MeSH data available.


Related in: MedlinePlus