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Hypothyroidism to hyperthyroidism: an immunological pendulum swing from two extreme poles – a case series
  1. Antoni R Kafrouni Gerges,
  2. Sara N Clark and
  3. Hassan Shawa
  1. Department of Endocrinology, Albany Medical Center Hospital, Albany, New York, USA
  1. Correspondence to Dr Hassan Shawa, shawaH{at}


We report two women who were diagnosed with hypothyroidism due to what was thought to be Hashimoto’s thyroiditis 18 and 16 years ago, respectively. They had been euthyroid on stable doses of levothyroxine for many years, and they presented to our clinic with clinically and biochemically overt hyperthyroidism that persisted even after stopping levothyroxine. Immunological and imaging workups were consistent with Graves’ disease. Both patients were treated medically and then received definitive treatment. To our knowledge, the intervals for these two conversions are among the longest conversion intervals reported in the medical literature.

  • endocrine system
  • thyroid disease

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  • Contributors ARKG was involved in the planning, conduct, reporting, conception and design as well as acquisition of data he also planned and conducted the review of literature. HS and SNC were involved in conception and design, analysis and interpretation of data.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed

  • Patient consent for publication Not required.