Hong Seong Eun, Choo Jin Woo, Lim Soo Kyung, Lee Seong Jin, Park Ji Won, Kim Sung Eun, Kim Jong Hyeok, Park Choong Kee
Department of Internal Medicine, Hallym University College of Medicine, Anyang, Korea.
Department of Internal Medicine, Seoul Women's Hospital, Incheon, Korea.
Korean J Gastroenterol. 2018 Jun 25;71(6):354-358. doi: 10.4166/kjg.2018.71.6.354.
Concurrent presentation of acute hepatitis A virus (HAV) infection and Graves' disease has not been reported in literature worldwide. Although there is no well-established mechanism that explains the induction of Graves' disease by HAV to date, our case suggests that HAV infection may be responsible for inducing Graves' disease. A healthy 27-year-old female presented fever, palpitation, and diarrhea, and she was subsequently diagnosed as acute HAV infection. Concurrently, she showed hyperthyroidism, and the diagnosis was made as Graves' disease. She had never had symptoms that suggested hyperthyroidism, and previous thyroid function test was normal. Acute HAV infection was recovered by conservative management, however, thyroid dysfunction was maintained even after normalization of liver enzymes. Methimazole was used to treat Graves' disease. We report a case of concurrent acute HAV infection and Graves' disease in a patient without preexisting thyroid disease. This suggests that HAV infection may be a trigger for an autoimmune thyroid disease in susceptible individuals.
急性甲型肝炎病毒（HAV）感染与格雷夫斯病同时出现的情况在全球文献中尚未见报道。尽管迄今为止尚无明确的机制来解释HAV如何诱发格雷夫斯病，但我们的病例提示HAV感染可能是诱发格雷夫斯病的原因。一名27岁健康女性出现发热、心悸和腹泻，随后被诊断为急性HAV感染。同时，她表现出甲状腺功能亢进，诊断为格雷夫斯病。她既往从未有过提示甲状腺功能亢进的症状，之前的甲状腺功能检查也正常。急性HAV感染经保守治疗后康复，但即使肝酶恢复正常，甲状腺功能障碍仍持续存在。使用甲巯咪唑治疗格雷夫斯病。我们报告一例既往无甲状腺疾病的患者同时发生急性HAV感染和格雷夫斯病的病例。这表明HAV感染可能是易感个体自身免疫性甲状腺疾病的触发因素。
