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Alan Chun Hong Lee Division of Endocrinology and Metabolism, Department of Medicine, Queen Mary Hospital, Hong Kong, China
Department of Medicine I, Johannes Gutenberg University Medical Center, Mainz, Germany

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George J. Kahaly Department of Medicine I, Johannes Gutenberg University Medical Center, Mainz, Germany

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treatment modalities of Graveshyperthyroidism (GH). Systemic glucocorticoids (GCs) were commonly employed in active GO since the 1950s. Over the past decade, we have witnessed the emergence of novel therapeutics which better target the immunological

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Meihua Jin Division of Endocrinology and Metabolism, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine and School of Medicine, Seoul, Republic of Korea

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Ahreum Jang Division of Endocrinology and Metabolism, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
Division of Endocrinology and Metabolism, Department Internal Medicine, Dankook University College of Medicine, Cheonan, Republic of Korea

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Chae A Kim Division of Endocrinology and Metabolism, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea

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Tae Yong Kim Division of Endocrinology and Metabolism, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea

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Won Bae Kim Division of Endocrinology and Metabolism, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea

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Young Kee Shong Division of Endocrinology and Metabolism, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea

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Min Ji Jeon Division of Endocrinology and Metabolism, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea

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Won Gu Kim Division of Endocrinology and Metabolism, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea

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Introduction Graveshyperthyroidism is an autoimmune disease in which thyrotropin (thyroid-stimulating hormone (TSH)) receptor antibody (TRAb) stimulates thyroid follicular cells, resulting in thyrotoxicosis and enlargement of the thyroid

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George J. Kahaly Department of Medicine I, Johannes Gutenberg University (JGU) Medical Center, Mainz, Germany

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Luigi Bartalena Department of Medicine and Surgery, University of Insubria, Varese, Italy

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Lazlo Hegedüs Department of Endocrinology and Metabolism, Odense University Hospital, Odense, Denmark

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Laurence Leenhardt Thyroid and Endocrine Tumors Unit, Pitié Salpêtrière Hospital, Sorbonne University, Paris, France

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Kris Poppe Endocrine Unit, CHU Saint-Pierre, Université Libre de Bruxelles (ULB), Brussels, Belgium

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Simon H. Pearce Department of Endocrinology, Institute of Genetic Medicine, Newcastle University, Newcastle upon Tyne, United Kingdom

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with suspected Graveshyperthyroidism. TSH-R-Ab are specific biomarkers for GD [ 2 , 22 ]. Most immunoassays today use a competitive-binding assay and measure what are referred to as TSH-R binding inhibitory immunoglobulins (TBII). Binding

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J Karmisholt Department of Endocrinology, Aalborg University Hospital, Aalborg, Denmark
Department of Clinical Institute, Aalborg University, Aalborg, Denmark

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S L Andersen Department of Clinical Institute, Aalborg University, Aalborg, Denmark
Department of Clinical Biochemistry, Aalborg University Hospital, Aalborg, Denmark

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I Bulow-Pedersen Department of Endocrinology, Aalborg University Hospital, Aalborg, Denmark
Department of Clinical Institute, Aalborg University, Aalborg, Denmark

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A Krejbjerg Department of Oncology, Aalborg University Hospital, Aalborg, Denmark

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B Nygaard Department of Endocrinology and Internal Medicine, Herlev University Hospital, Copenhagen, Denmark

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A Carlé Department of Endocrinology, Aalborg University Hospital, Aalborg, Denmark
Department of Clinical Institute, Aalborg University, Aalborg, Denmark

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Introduction Graveshyperthyroidism (GH) is an autoimmune disease mainly affecting the thyroid gland ( 1 , 2 ). The disease is usually transient with remission occurring within a period of 1–2 years after treatment with anti-thyroid drugs

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Earn H. Gan Institute of Genetic Medicine, International Centre for Life, Newcastle upon Tyne, United Kingdom

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Anna L. Mitchell Institute of Genetic Medicine, International Centre for Life, Newcastle upon Tyne, United Kingdom

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Ruth Plummer Institute of Genetic Medicine, International Centre for Life, Newcastle upon Tyne, United Kingdom

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Simon Pearce Institute of Genetic Medicine, International Centre for Life, Newcastle upon Tyne, United Kingdom

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Petros Perros Institute of Genetic Medicine, International Centre for Life, Newcastle upon Tyne, United Kingdom

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by thyroid disorders. This report describes a case of Graves hyperthyroidism after 8 years of tremelimumab therapy. We speculate a causal relationship between tremelimumab therapy and the development of Graves disease, and highlight the importance

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Tetsuya Mizokami Tajiri Thyroid Clinic, Kumamoto, Japan

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Katsuhiko Hamada Tajiri Thyroid Clinic, Kumamoto, Japan

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Tetsushi Maruta Tajiri Thyroid Clinic, Kumamoto, Japan

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Kiichiro Higashi Tajiri Thyroid Clinic, Kumamoto, Japan

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Junichi Tajiri Tajiri Thyroid Clinic, Kumamoto, Japan

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What Is Known about This Topic? • Anterior neck pain and fever, caused by radiation thyroiditis, is a rare occurrence after 131 I therapy for Graves' hyperthyroidism. In addition, the ultrasonographic findings have not been well described

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Elena Sabini Department of Clinical and Experimental Medicine, Endocrinology Units, University of Pisa and University Hospital of Pisa, Pisa, Italy

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Ilaria Ionni Department of Clinical and Experimental Medicine, Endocrinology Units, University of Pisa and University Hospital of Pisa, Pisa, Italy

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Roberto Rocchi Department of Clinical and Experimental Medicine, Endocrinology Units, University of Pisa and University Hospital of Pisa, Pisa, Italy

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Paolo Vitti Department of Clinical and Experimental Medicine, Endocrinology Units, University of Pisa and University Hospital of Pisa, Pisa, Italy

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Claudio Marcocci Department of Clinical and Experimental Medicine, Endocrinology Units, University of Pisa and University Hospital of Pisa, Pisa, Italy

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Michele Marinò Department of Clinical and Experimental Medicine, Endocrinology Units, University of Pisa and University Hospital of Pisa, Pisa, Italy

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deterioration of Graves’ orbitopathy in patients with Graveshyperthyroidism. A similar release of autoantigens may occur at the eye level resulting in the development of Graves’ orbitopathy. What Does This Case Report Add? To our knowledge

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Allan Carlé Department of Endocrinology, Aalborg University Hospital, Aalborg, Denmark
Department of Clinical Institute, Aalborg University, Aalborg, Denmark

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Nils Knudsen Department of Endocrinology I, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark

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Torben Jørgensen Centre for Clinical Research and Prevention, Capital Region of Denmark, Copenhagen, Denmark
Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark

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Bettina Thuesen Centre for Clinical Research and Prevention, Capital Region of Denmark, Copenhagen, Denmark

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Jesper Karmisholt Department of Endocrinology, Aalborg University Hospital, Aalborg, Denmark
Department of Clinical Institute, Aalborg University, Aalborg, Denmark

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Stine Linding Andersen Department of Endocrinology, Aalborg University Hospital, Aalborg, Denmark
Department of Clinical Biochemistry, Aalborg University Hospital, Aalborg, Denmark

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Inge Bülow Pedersen Department of Endocrinology, Aalborg University Hospital, Aalborg, Denmark
Department of Clinical Institute, Aalborg University, Aalborg, Denmark

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studies [ 5 ], have shown a lower risk during pregnancy of developing autoimmune thyroid disease such as Graveshyperthyroidism and autoimmune hypothyroidism. Due to the so called “rebound phenomenon,” the risk of autoimmune thyroid disease after delivery

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Megumi Fujikawa Fujikawa-Megumi Clinic, Mizutani 2-7-7, Higashi-ku, Fukuoka, Japan
Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Maidashi 3-1-1, Higashi-ku, Fukuoka, Japan

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Ken Okamura Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Maidashi 3-1-1, Higashi-ku, Fukuoka, Japan

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Introduction About 100 years ago, iodide was introduced for the treatment of Graveshyperthyroidism (GD) ( 1 , 2 ). Inorganic iodide administration rapidly reduced serum thyroid hormone levels in GD patients ( 3 , 4 , 5 , 6 ), however, a

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Mahdi Kamoun Endocrinology and Metabolism Department

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Michèle d'Herbomez Department of Nuclear Medicine, Lille University Hospital, Lille

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Christine Lemaire Department of Endocrinology, Regional Hospital of Béthune, Béthune

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Armelle Fayard Endocrinology and Metabolism Department

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Rachel Desailloud Endocrinology and Metabolism Department, Amiens University Hospital, Amiens, France

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Damien Huglo Department of Nuclear Medicine, Lille University Hospital, Lille

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Jean-Louis Wemeau Endocrinology and Metabolism Department

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Background: Coexistence of thyroid-stimulating hormone (TSH)-secreting pituitary adenoma (TSHoma) with Graves' disease has been rarely reported. We describe a female patient displaying TSHoma with Graves' disease and who presented initially with inappropriate TSH values. Case Report: A 36-year-old woman presented with signs of thyrotoxicosis, small and vascular goiter and mild bilateral exophthalmos. Thyroid function tests showed hyperthyroxinemia and normal TSH values despite the use of different assays. Heterophile antibody testing result was negative. The patient underwent total right lobectomy with partial left lobectomy after 18 months of carbimazole treatment. Histology confirmed Graves' disease. Symptoms of thyrotoxicosis recurred 2 months later. Thyroid function tests showed hyperthyroxinemia and elevated TSH values. Investigations were consistent with a 10-mm TSHoma. The patient underwent a trans-sphenoidal tumor resection following preoperative lanreotide preparation. Histological examination and immunocytochemistry concluded to a pure TSH-producing tumor. There was no evidence of tumor recurrence after 18 years of follow-up. Conclusion: Association of TSHoma with Graves' disease should be carefully taken into account, especially when TSH values are not compatible with either the clinical history or other thyroid functions tests.

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