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Journal of Case Reports
Graves’ Disease with Non-functioning Parathyroid Adenoma: An Uncommon Association of Common Diseases
Anindita Sinha1, Arnab Pal2, Kyrshanlang G Lynrah3
From the Departments of Radiodiagnosis1 and Biochemistry2, Post Graduate Institute of Medical Education and Research, Chandigarh, India and Department of Medicine3, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, India
Corresponding Author:
Dr. Arnab Pal
Email: pal.arnab@pgimer.edu.in
Received: 20-MAY-2014 Accepted: 22-JUN-2014 Published Online: 15-JUL-2014
DOI: http://dx.doi.org/10.17659/01.2014.0064
Abstract
Data on coexisting Graves’ disease (GD), hypoparathyroidism, and autoimmune haemolytic anaemia are limited. Here we report an uncommon case of autoimmune disorder causing Graves’ disease with autoimmune haemolytic anaemia and along with mineralisation of basal ganglia. The patient had a parathyroid nodule along with normal serum calcium and parathyroid hormone levels. The probable cause of this nodule is a compensatory response to autoimmune hypoparathyroidism. Patient has increased levels of T3, T4, free T4, thyroid binding globulin and antithyroglobulin antibody. The ANA and anti dsDNA antibody were within normal limit. The relative deficiency of CD4+FOXP3+Treg cells in peripheral blood also confirms the autoimmune pathogenesis of the disease process. The patient responded to the steroid therapy and later on maintained with low dose carbimazole.
Keywords : Adenoma, Anemia, Hemolytic, Autoimmune, Hypoparathyroidism, Hypocalcemia, Parathyroid Neoplasms.
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