PMID- 10426583
OWN - NLM
STAT- MEDLINE
DCOM- 19990902
LR  - 20190905
IS  - 0918-8959 (Print)
IS  - 0918-8959 (Linking)
VI  - 46
IP  - 1
DP  - 1999 Feb
TI  - A case of Graves' disease associated with autoimmune hepatitis and mixed 
      connective tissue disease.
PG  - 173-7
AB  - The patient was a woman of forty-eight. Liver dysfunction was pointed out at the 
      age of forty-five. She was admitted to hospital because of her hyperthyroidism. 
      Her palmar skin was wet and her fingers were swollen like sausages. She had a 
      diffuse and elastic hard goiter with a rough surface. The serum levels of free T3 
      (9.6 pg/mL) and free T4 (3.76 ng/dL) were high and that of TSH (0.11 microU/mL) 
      was low. The activity of TSH-binding inhibitory immunoglobulin (TBII) was 89%. 
      The uptake rate of 123I to the thyroid was 55.1% and the uptake pattern was 
      nearly diffuse. The goiter was proved to contain several nodules by 
      ultrasonography, but aspiration cytology showed no malignant cells. She was 
      diagnosed to have Graves' disease with adenomatous goiter. She also had high ALT 
      (34 IU/L) and gamma-globulin (1.97 g/dL). She had positive antinuclear antibody 
      (speckled type), positive anti-ribosomal nuclear protein antibody, and positive 
      LE cell phenomenon. The liver biopsy revealed mononuclear cell infiltration with 
      fibrosis in the portal area. These data indicated that she also had autoimmune 
      hepatitis (AIH) and mixed connective tissue disease (MCTD). The analysis of human 
      leukocyte antigen (HLA) showed positive A11 which had been reported to relate to 
      Graves' disease, and positive DR4 which had been reported to relate to AIH and 
      MCTD. These results suggested that HLA would determine susceptibility to three 
      distinct autoimmune diseases in this case.
FAU - Inoue, K
AU  - Inoue K
AD  - Metabolism and Endocrinology Unit, Clinical Research Institute, National Kyushu 
      Medical Center Hospital, Fukuoka, Japan.
FAU - Okajima, T
AU  - Okajima T
FAU - Tanaka, E
AU  - Tanaka E
FAU - Ando, B
AU  - Ando B
FAU - Takeshita, M
AU  - Takeshita M
FAU - Masuda, A
AU  - Masuda A
FAU - Yamamoto, M
AU  - Yamamoto M
FAU - Sakai, K
AU  - Sakai K
LA  - eng
PT  - Case Reports
PT  - Journal Article
PL  - Japan
TA  - Endocr J
JT  - Endocrine journal
JID - 9313485
RN  - 0 (Antibodies, Antinuclear)
RN  - 0 (Autoantibodies)
RN  - 0 (HLA Antigens)
RN  - 0 (Immunoglobulins, Thyroid-Stimulating)
RN  - 0 (Receptors, Thyrotropin)
RN  - 0 (Ribonucleoproteins)
RN  - 0 (thyrotropin-binding inhibitory immunoglobulin)
RN  - 06LU7C9H1V (Triiodothyronine)
RN  - 9002-71-5 (Thyrotropin)
RN  - EC 2.6.1.2 (Alanine Transaminase)
RN  - Q51BO43MG4 (Thyroxine)
SB  - IM
MH  - Alanine Transaminase/blood
MH  - Antibodies, Antinuclear/blood
MH  - Autoantibodies/blood
MH  - Female
MH  - Goiter/complications/diagnosis
MH  - Graves Disease/*complications/diagnosis/immunology
MH  - HLA Antigens/analysis
MH  - Hepatitis, Autoimmune/*complications/diagnosis/immunology
MH  - Humans
MH  - Immunoglobulins, Thyroid-Stimulating
MH  - Liver/diagnostic imaging/pathology
MH  - Middle Aged
MH  - Mixed Connective Tissue Disease/*complications/diagnosis/immunology
MH  - Radionuclide Imaging
MH  - Receptors, Thyrotropin/blood
MH  - Ribonucleoproteins/immunology
MH  - Thyroid Gland/diagnostic imaging
MH  - Thyrotropin/blood
MH  - Thyroxine/blood
MH  - Triiodothyronine/blood
MH  - Ultrasonography
EDAT- 1999/07/30 00:00
MHDA- 1999/07/30 00:01
CRDT- 1999/07/30 00:00
PHST- 1999/07/30 00:00 [pubmed]
PHST- 1999/07/30 00:01 [medline]
PHST- 1999/07/30 00:00 [entrez]
AID - 10.1507/endocrj.46.173 [doi]
PST - ppublish
SO  - Endocr J. 1999 Feb;46(1):173-7. doi: 10.1507/endocrj.46.173.