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| Year : 1983 | Volume
: 29
| Issue : 4 | Page : 253-4 |
Familial thyroid disease : Grave's disease and non-toxic goitre (a case report).
Rais NN, Kalra PP, Bhandarkar SD, Satoskar RS
How to cite this article:
Rais N N, Kalra P P, Bhandarkar S D, Satoskar R S. Familial thyroid disease : Grave's disease and non-toxic goitre (a case report). J Postgrad Med 1983;29:253 |
How to cite this URL:
Rais N N, Kalra P P, Bhandarkar S D, Satoskar R S. Familial thyroid disease : Grave's disease and non-toxic goitre (a case report). J Postgrad Med [serial online] 1983 [cited 2023 Sep 26];29:253. Available from: https://www.jpgmonline.com/text.asp?1983/29/4/253/5499 |
Grave's disease can affect several members of a family and even several generations of a kindred.[3] The relatives of such patients may suffer from a variety of thyroidal illnesses including non-toxic diffuse goitre.[2]
We report below a case of Grave's disease in whose kindred Grave's disease and non-toxic goitre were present in eight members of five generations.
E.P., a 47 year old housewife, came to us in April 1962 with a recurrence of hyperthyroidism after a thyroidectomy performed in 1952. She had tachycardia, tremor and exophthalmos, along with a small goitre and previous thyroidectomy and tracheostomy scars. The 131I uptakes were as follows: 4 hour uptake 61%, 48 hour uptake 76%, PB 131I at 48 hours 0.76% of the dose per litre. On treating her with 3 mCi of radioiodine 131I she has remained euthyroid to date (upto March, 1983).
During the period of her follow up (1962-1983), she brought to us several of her close relatives, who on examination and investigation were found to have thyrotoxicosis or non-toxic goitre. These subjects were closely questioned for a history of similar disease in their kindred.
The family tree extending over five generations [Fig. 1] constructed on the basis of actual observation of patients and information obtained from them about their relatives, showed a lot of inter-marriages between two families (P. & D). There were four subjects with hyperthyroidism (including the propositus E.P.) and four with non-toxic goitre, in this kindred of 37 subjects.
Hereditary factors play a role in the genesis of Grave's disease as well as familial non-toxic goitre.[2] The former is an autoimmune disorder[4] whereas evidence that the latter also is possibly autoimmune in nature has been presented.[1]
Autoimmune thyroiditis encompasses a wide spectrum of thyroidal illnesses, with Grave's disease due to thyroid stimulating immunoglobulin at one end, and hypothyroidism with destructive autoantibodies at the other.[5] The familial nontoxic goitres are placed somewhere along this spectrum and therefore it is likely that these conditions are all variations in the genetic expression of a basic autoimmune thyroid disorder.
We acknowledge the Dean, Seth G.S. Medical College and K.E.M. Hospital, for allowing us to permit publication of the hospital data.
| 1. | Doniach, D., Cudworth, A. G., Khoury, E. L. and Bottazzo, G. F.: Auto-immunity and the HLA-system in endocrine diseases. In, "Recent Advances in Endocrinology and Metabolism. Number 2, Editor: J. L. H. O'Riordan, Churchill Livingstone, London, 1982, pp. 99-132.  |
| 2. | Kitchin, D. F., and Weinstein, I. B.: Genetic factors in thyroid disease In, "The Thyroid". Editors: S. C. Werner and S. H. Ingbar, Harper and Row, Publishers, Hagerstown, Maryland, 1978, pp. 480-501. |
| 3. | Vaidya, V. A., Bongiovanni, A. M., Parks, J. S., Tenor, A. and Kirkland, R. T.: Twenty-two years' experience in the medical management of juvenile thyrotoxicosis. Paediatrics, 54: 565-570, 1974. |
| 4. | Volpe, R.: The pathogenesis of Grave's disease-An overview. Clinics in Endocrinol. & Metab., 7: 3-29, 1978. |
| 5. | Volpe, R.: Lymphocytic (Hashimoto's) thyroiditis. In, "The Thyroid". Editors: S. C. Werner and S. H. Ingbar. Harper and Row, Publishers, Hagerstown, Maryland, 1978 pp. 996-1008. |
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