[The transformation of Basedow's struma into nodular goiter: a reason for recurrence of hyperthyroidism].

Graves' disease is characterized by a diffuse and homogeneously hyperfunctioning goiter, presumably caused by thyroid stimulating, TSH-receptor directed antibodies (TRAB). However, in many patients the serum concentration of TRAB is in no way parallel to the severity of the clinical course of Graves' hyperthyroidism. In particular, hyperthyroidism may persist or repeatedly relapse over many years despite the absence of high TRAB titers. The present study summarizes the existing evidence that this course of Graves' disease may be due to gradually evolving autonomously growing and functioning micro- or macronodules within the originally diffuse goiter.