• Clinical and Experimental Pediatrics
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• v.57 no.6
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• pp.287-291
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• 2014

Moyamoya disease is a cerebrovascular condition that results in the narrowing of the vessels of the circle of Willis and collateral vessel formation at the base of the brain. Although relationships between Graves' disease and cerebrovascular accidents in Moyamoya disease are obscure, the coexistence of the two diseases is noteworthy. Moyamoya disease has been rarely reported in adolescent patients with thyrotoxicosis. Recently, we encountered two adolescent Korean patients with Moyamoya disease associated with Graves' disease who presented with episodic right-sided hemiparesis and syncope. These two girls who had Graves' disease had no history of other diseases or head trauma. A thyroid function test revealed a euthyroid state and a high thyroid-stimulating hormone (TSH) receptor antibody titer at that time. The patients were diagnosed with Moyamoya disease based on brain magnetic resonance angiography and cerebral four-vessel angiography. The patients underwent cranial revascularization by encephalo-duroarterio-synangiosis as soon as a diagnosis was made, which resulted in successful symptom resolution. They fared well and had no additional neurological symptoms as of their last follow-up visits. Here, we report these two cases of confirmed Moyamoya disease complicated by Graves' disease with a review of the literature, and discuss the possible association between the two diseases. To our knowledge, this is the first report in South Korea on Moyamoya disease associated with Graves' disease in adolescents with a euthyroid.

• International journal of thyroidology
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• v.10 no.1
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• pp.50-55
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• 2017

Sweet's syndrome, or acute febrile neutrophilic dermatosis, occurs in association with autoimmune diseases such as Hashimoto's thyroiditis but is rare in Graves' disease, in which all cases are induced by propylthiouracil (PTU). We report a case of Sweet's syndrome in a patient with Graves' disease treated with methimazole (MMI) during three weeks. A 34-year-old man presented with the acute onset of high fever, skin rashes on the whole body, arthralgia, and acroparesthesia. Laboratory results showed leukocytosis and elevated C-reactive protein. MMI first stopped and antibiotics and antihistamine therapy started, but his symptoms dramatically improved after oral prednisolone. Graves' disease has again been treated by MMI because of his aggravated ophthalmopathy. After one year of retreatment with MMI, there has been no recurrence of Sweet's syndrome, supporting that Sweet's syndrome in this case was not related to MMI exposure. To our knowledge, this is the first report of Sweet's syndrome associated with Graves' disease per se but not PTU or MMI use.

• The Korean Journal of Nuclear Medicine
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• v.7 no.2
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• pp.13-26
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• 1973

In order to study the role of LATS in the pathogenesis of the Graves' disease, the serum activity of the LATS was determined by the bioassay of the modified McKenzie method. The subjects examined in the study consisted of 76 individuals including 12 cases of normal control, 54 cases with typical Graves' disease and 10 cases of chronic thyroiditis. The data observed in the patients with the Graves' disease were analyzed in comparison with the clinical features, laboratory findings, and responsiveness to the treatment. The results obtained are as follows: 1. None of the subjects which did not have the Graves' disease showed a positive LATS activity, except one case with the chronic thyroiditis. 2. Twenty-two out of the 54 cases with the Graves' disease showed positive results for LATS(40.7%). The positivity was significantly higher in the patients who had been treated with anti. thyroid regimen but still showed hyperthyroidism than in the patients who had not been treated. 3. The activity of LATS was gradually decreased or even became absent as the hyperthyroidism was corrected after the treatment. 4. No significant difference was noticed in age & sex between the positive and negative groups of LATS. 5. There was no evidence of significant correlation between the LATS activity and clinical features.

• Clinical and Experimental Pediatrics
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• v.53 no.4
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• pp.585-591
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• 2010

Purpose : Graves' disease is the most common cause of hyperthyroidism in children and adolescents. In this study, we investigated the natural course and the prognostic factors of Graves' disease in Korean children and adolescents. Methods : One-hundred thirteen (88 girls and 25 boys) patients were included in this study. A retrospective analysis was made of all patients who were diagnosed with Graves' disease. The following parameters were recorded and analyzed: patient's sex, age at diagnosis, duration of disease, laboratory findings, symptoms and signs, and family history of autoimmune thyroid disease. Results : All patients were initially treated with antithyroid drugs, either methimazole (93.8%) or propylthiouracil (6.2%). Antithyroid drugs had been discontinued in 75 (66.4%) of 113 patients. Of these 75 patients, 23 (20.4%) relapsed after $25.5{\pm}33.7$ months. Thirteen (11.5%) of 23 patients, who experienced the first relapse, showed a second remission. However, 2 (1.8%) of 13 patients relapsed again. Euthyroid state could not be achieved by antithyroid drugs in 1 patient, and radioactive iodine therapy was performed. The older the patient at diagnosis, the greater the likelihood of remission ($P$=0.034). Conclusion : Age at diagnosis seems to be a prognostic factor in Korean children and adolescents with Graves' disease, and should be taken into account in treatment plan determination.

• Childhood Kidney Diseases
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• v.25 no.1
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• pp.40-43
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• 2021

Enuresis is intermittent urinary incontinence during sleep at night in children aged 5 years or older. The main pathophysiology of enuresis involves nocturnal polyuria, abnormal sleep arousal, and low functional bladder capacity. In rare cases, enuresis is an early symptom of endocrine disorders such as diabetes or thyroid disorders. Herein, we report a case of a 12-year-old girl with enuresis as a rare initial presentation of Graves' disease. She complained of nocturnal enuresis from a month before visiting our clinic. She also complained of urinary frequency, headache, and weight loss. On physical examination, she had tachycardia, intention tremors, and a diffuse goiter on her anterior neck with bruit on auscultation. Her thyroid function test results revealed hyperthyroidism, and Graves' disease was diagnosed as the thyroid stimulating hormone receptor autoantibody was positive. After treatment for Graves' disease with methimazole, symptoms of enuresis resolved within 2 weeks as she became clinically and biochemically euthyroid. In children with secondary enuresis, Graves' disease should be considered as a differential diagnosis, and signs of hyperthyroidism should be checked for carefully.

• Korean Journal of Head & Neck Oncology
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• v.15 no.1
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• pp.61-65
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• 1999

Introduction: The surgical treatment of Graves' disease has several advantage such as rapid and long lasting therapeutic effect, relatively low incidence of postoperative hypothyroidism and recurrence. Because of less frequent but serious postoperative complications, the operation have not been casually used for treatment of Graves' disease. Hypoclacemia, hoarseness and hematomas are common complications after operative treatment. However, the causative mechanisms of these complications have not been well explained. Objective: We aimed to analyze the risk factors affecting the occurance of complications in surgical treatment for Graves' disease and to evaluate what are the causative mechanisms of postoperative complications. Patients and Methods: From January 1985 to December 1998, a total of 668 surgically treated patients for Graves' disease were enrolled in this study. The incidence of postoperative complications were analyzed in relation to types of surgery, preoperaive preparation, specimen weight, bleeding amount and remnant weight. Results: Postoperative complication was developed in 108(16.2%) of 668 patients. The most common complication was transient hypocalcemia in 85 cases(12.7%). Other complications were: Hematoma in 9 cases(1.3%), transient hoarseness in 5 cases(0.7%), permanent hypocalcemia in 6 cases(0.9%), permanent hoarseness in 3 case(0.4%). The important etiologic factors affecting the occurance of complications were preoperative preparation, perioperative thyroid weight, and remnant thyroid weight. Since 1993, the incidence of complication was more decreased than that in before. Conclusion: To decrease the incidence of postoperative complications of Graves' disease, the patients should be selected carefully, sufficient preoperative preparation should be achieved, and the operation should be performed by well-experienced surgeons.

• The Korean Journal of Nuclear Medicine
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• v.9 no.1
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• pp.1-2
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• 1975

• Journal of Chest Surgery
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• v.47 no.3
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• pp.294-297
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• 2014

Cardiac complications such as arrhythmia and heart failure are common in Graves disease. Early detection and proper treatment of hyperthyroidism are important because cardiac complications are reported to be reversible if the thyroid function is normalized by medical treatment. We report here a case of cardiac complication of Graves disease that was too late to reverse with medical treatment and required surgical treatment.

• Korean Journal of Head & Neck Oncology
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• v.11 no.2
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• pp.185-190
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• 1995

Transient and permanent hypocalcemia after various types of thyroidectomy are well-known complications, and are more common after bilateral subtotal thyroidectomy for Graves' disease. However, their causative mechanisms are not well explained. Four hundred thirty patients with Graves' disease who underwent bilateral subtotal thyroidectomy from January 1983 through December 1992 were analyzed to determine the incidence and risk factors for the development of postthyroidectomy hypocalcemia. Of the 430 patients underwent bilateral subtotal thyroidectomy, symptomatic transient and permanent hypocalcemia developed in 24.2 % (104/430) and 0.5 % (2/430), respectively. With analysis of potential risk factors, the increase in incidence of the postthyroidectomy hypocalcemia was found to be statistically related to the larger thyroid gland, the larger amount of blood loss during thyroidectomy, the smaller remnant thyroid tissue, the higher levels of serum alkaline phosphatase and TBII titers. Our data suggest that impairment of parathyroid gland blood supply, degree of thyrotoxic osteodystrophy and autoimmune process of each patient are regarded as main mechanisms of postthyroidectomy hypocalcemia in patients with Graves' disease.

• Journal of Yeungnam Medical Science
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• v.36 no.3
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• pp.273-280
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• 2019

Cerebral venous sinus thrombosis (CVT) is a rare cerebrovascular condition accounting for 0.5-1% of all types of strokes in the general population. Hyperthyroidism is associated with procoagulant and antifibrinolytic activity, thereby precipitating a hypercoagulable state that predisposes to CVT. We report the case of a 31-year-old Korean man with massive CVT and diagnosis of concomitant Graves' disease at admission. Early diagnosis and prompt treatment of CVT are important to improve prognosis; therefore, CVT should be considered in the differential diagnosis in all patients with hyperthyroidism presenting with neurological symptoms.