Unusual events preceding hyperthyroidism with diffuse goiter

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Abstract
Two unique patients with hyperthyroidism are presented. A 48 yr old woman with a family history of Graves'' disease was first evaluated and treated for a toxic adenoma with radioactive iodine. Three months later, she was again hyperthyroid, was found to have a diffuse thyromegaly, and was treated with radioactive iodine for the 2nd time. This patient represents the 1st reported case of 2 sequential forms of endogenous hyperthyroidism. The 2nd pattient, a 64 yr old woman, had well-documented hypothyroidism that was presumably primary. She was admitted in thyroid storm and subsequently died. The autopsy disclosed characteristic changes in the thyroid of hyperthyroidism and a normal pituitary gland. The timing of the onset of Graves'' disease with hyperthyroidism cannot be accurately determined.

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