|Year : 1983 | Volume
| Issue : 4 | Page : 253-4
Familial thyroid disease : Grave's disease and non-toxic goitre (a case report).
NN Rais, PP Kalra, SD Bhandarkar, RS Satoskar
N N Rais
|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;29:253-4
|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 ];29:253-4
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. The relatives of such patients may suffer from a variety of thyroidal illnesses including non-toxic diffuse goitre.
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. The former is an autoimmune disorder whereas evidence that the latter also is possibly autoimmune in nature has been presented.
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. 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.|