Efficacy of low-dose methimazole in control of multiple relapses of Graves’ hyperthyroidism: a case report

Journal of Medical Case Reports

Atieh Amouzegar¹  Hengameh Abdi¹  Fereidoun Azizi¹ 

[1] Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, No 24, Aerabi St, Daneshjoo Blv, Velenjak, Tehran, Iran;

关键词: Graves’ disease;    Hyperthyroidism;    Methimazole;    Relapse;    Case report;   

DOI  :  10.1186/s13256-021-02788-4

来源: Springer

【 摘 要 】

IntroductionMethimazole (MMI) is the treatment of choice for patients with Graves’ disease. The major drawback of this treatment is the relapse of hyperthyroidism in half of the patients after discontinuation of the recommended conventional 12–18 months of MMI treatment. TSH receptor antibody (TRAb) concentration is recognized as the strongest predictor of hyperthyroidism relapse. In this case report, efficacy of low-dose MMI to control hyperthyroidism even after multiple recurrences in the setting of normal TRAb concentrations is shown.Case presentationAn 80-year-old Iranian woman with Graves’ disease was treated with MMI for 31 years. While receiving treatment, she always had a normal serum TRAb concentration; however, three times during the 31 years she decided to stop MMI therapy, and each time the disease recurred 16–21 months after MMI withdrawal. It is noteworthy that she maintained euthyroidism with the low-dose 1.25–2.5 mg MMI daily without any adverse events during three decades of treatment.ConclusionsNormal serum TRAb is not a sufficiently strong marker to predict relapse of Graves’ hyperthyroidism. Long-term therapy with low-dose MMI is an effective and safe treatment to sustain euthyroidism.

【 授权许可】

CC BY