Oscillating hypothyroidism and hyperthyroidism: A rare autoimmune syndrome

Abstract

Graves’ disease is an autoimmune thyroid disorder with overproduction of thyroid hormones secondary to the production of thyroid-stimulating hormone receptor (TSH-R) stimulating antibodies (TSAbs). It is very common for Graves’ disease patients to convert to a hypothyroid state especially in end-stage Graves’ disease or after iodine ablation. These patients require lifelong thyroxin replacement therapy. In this case report, we describe a rare phenomenon known as “oscillating hypo-and hyperthyroidism”. In this rare entity of autoimmune endocrine disorder patients with hypothyroidism spontaneously convert to Graves’ disease.