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Diagnosis and Treatment > Signs and Symptoms

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  • Heat intolerance x
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Wei Lin Tay Department of Endocrinology, Singapore General Hospital, Singapore, Singapore

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Wann Jia Loh Department of Endocrinology, Changi General Hospital, Singapore, Singapore

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Lianne Ai Ling Lee Department of Pathology, Sengkang Health, Singapore, Singapore

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Chiaw Ling Chng Department of Endocrinology, Singapore General Hospital, Singapore, Singapore

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Summary

We report a patient with Graves’ disease who remained persistently hyperthyroid after a total thyroidectomy and also developed de novo Graves’ ophthalmopathy 5 months after surgery. She was subsequently found to have a mature cystic teratoma containing struma ovarii after undergoing a total hysterectomy and salpingo-oophorectomy for an incidental ovarian lesion.

Learning points:

  • It is important to investigate for other causes of primary hyperthyroidism when thyrotoxicosis persists after total thyroidectomy.

  • TSH receptor antibody may persist after total thyroidectomy and may potentially contribute to the development of de novo Graves’ ophthalmopathy.

Taxonomy:
Clinical Overview, Gland/Organ, Thyroid, Topic, Thyroid, Hormone, Thyroxine (T4), Triiodothyronine (T3), TSH, Condition/ Syndrome, Goitre (multinodular), Graves' disease, Graves' ophthalmopathy, Hyperthyroidism, Ovarian tumour, Struma ovarii, Thyroiditis, Thyrotoxicosis, Patient Demographics, Age, Adult, Gender, Female, Ethnicity, Asian - Chinese, Country of Treatment, Singapore, Diagnosis and Treatment, Signs and Symptoms, Bowel movements - bleeding, Diplopia, Dysphagia, Fatigue, Goitre, Heat intolerance, Hyperthyroidism, Menstrual disorder, Myasthaenia, Palpitations, Proptosis, Thyrotoxicosis, Tremulousness, Weight loss, Investigation, CT scan, FT3, FT4, Histopathology, MRI, Thyroid antibodies, TSH, TSH receptor antibodies, Intervention, Bilateral salpingo-oophorectomy, Hysterectomy, Resection of tumour, Salpingo-oophorectomy, Thyroidectomy, Medication, Carbimazole, Glucocorticoids, Levothyroxine, Prednisolone, Publication Details, Case Report Type, Unique/unexpected symptoms or presentations of a disease
DOI:
https://doi.org/10.1530/EDM-17-0109
Volume/Issue:
Volume 2017: Issue 1
Open access