Hyperthyroidism in a Renal Transplant Recipient

Abstract

We report a case of toxic multinodular goiter with severe symptomatic hyperthyroidism in a female diagnosed 5 months after successful renal transplantation. To our knowledge, this is the first well-documented case of hyperthyroidism in a renal transplant recipient that responded well to methimazole. Special attention should be made to the use of methimazole and the possible interaction with immunosuppressive drugs.

Incidence of Thyroid Dysfunction and Thyroid Cancer in Renal Transplant Recipients: A Single Center Experience

“…The occurrence of hyperthyroidism in transplant recipients receiving immunosuppressive therapy is extremely rare. [10,11] Furthermore, in end-stage renal disease, hyperthyroidism may occur with a frequency similar to that of the general population. [12] However, we observed a high prevalence of hyperthyroidism in transplant patients.…”

Resolution of Graves’ disease after renal transplantation

“…Immunosuppression with tacrolimus would not appear to adequately explain our findings as there have been three other reported cases of Graves’ disease presenting while on cyclosporine, another CI. Two of the three cases were in transplant recipients who were also receiving prednisone . MMF may modulate autoimmune thyroid disease, but its effects are unclear.…”

“…While non‐thyroidal illness syndrome and hypothyroidism are common in patients with ESRD, hyperthyroidism is rare. There are a few reported cases of Graves’ disease in adults with ESRD, even fewer cases in adult transplant recipients, and none in pediatric patients with advanced CKD . While most cases were successfully treated with I‐131 ablation or ATDs, there are no established treatment guidelines for this rare occurrence.…”