A 55-year-old female patient presented to the endocrine clinic with Grave’s disease. She was initially treated with carbimazole. After an early relapse, a decision was made to proceed with radioactive iodine therapy. Four days after radioiodine administration, she presented to the emergency department with chest tightness and dyspnea due to heart failure. Biochemistry revealed thyrotoxicosis an...

Grave’s disease is a common form of autoimmune thyroiditis which has been successfully treated with anti-thyroid drugs for more than half a century. However, these drugs may cause major complications including agranulocytosis, hepatotoxicity and immunological disturbances such as lupus erythematosus syndrome. Anti myeloperoxidase-antineutrophil cytoplasmic antibody (MPO-ANCA) mediated crescenti...

The double antibody radioimmunoassay of serum thyroid-stimulating hormone (TSH) allows measurement of circulating levels of the hormone in most normal subjects. The serum TSH level in normal subjects is 1.6 +/- 0.8muU/ml. Patients with non-toxic goitre and acromegaly have normal TSH levels. Values are always raised in hypothyroid patients (with primary thyroid disease) and are significantly low...

A 35-year-old woman with a 9-year history of Grave's disease delivered a male infant weighing 2,210 g at 32 weeks of gestation by caesarean section. The neonate developed thyrotoxicosis and, at the age of 24 h, was treated with oral carbimazole (500 µg every 8 h) and propranolol (2 mg/kg/day in two divided doses). He subsequently developed hypertension on day 4, which required therapy with amlo...

Thyrotoxic periodic paralysis (TPP) is rare in non-Orientals, and sporadic case reports were reported world-wide. Eight cases were reported in Arabs, including 3 Saudis. We present an additional case of TPP in a 38-year-old Saudi man, and review the literature on TPP in Arabs. Our patient presented with complete flaccid quadriplegia, 5 weeks after he was diagnosed with Graves' disease that was ...

Thyrotoxicosis is a common disorder, especially in women. The most frequent cause is Graves' disease (autoimmune hyperthyroidism). Other important causes include toxic nodular hyperthyroidism, due to the presence of one or more autonomously functioning thyroid nodules, and thyroiditis caused by inflammation, which results in release of stored hormones. Antithyroid drugs are the usual initial tr...

Most Muslims fast during the holy month of Ramadan. Patients with thyroid diseases do not normally need medication adjustment and are able to fast safely. On the other hand, hypothyroid patients are prescribed with thyroxine tablets, which should be taken on an empty stomach at bedtime or half an hour before Sohur. Hyperthyroid patients receiving treatment with methimazole or carbimazole have t...