TY - JOUR T1 - Autoimmune switch from hyperthyroidism to hypothyroidism in Graves’ disease JF - BMJ Case Reports JO - BMJ Case Reports DO - 10.1136/bcr-2020-236465 VL - 13 IS - 11 SP - e236465 AU - Preethi Padmanaban AU - Rohit Jain Y1 - 2020/11/01 UR - http://casereports.bmj.com/content/13/11/e236465.abstract N2 - We report a case of a 21-year-old young woman who was initially diagnosed with hyperthyroidism secondary to Graves’ disease and spontaneously switched to hypothyroidism in a year. While most autoimmune hypothyroidism is due to Hashimoto’s disease, in her case, we suspect that her hypothyroidism is due to a switch of antibody dominance from thyroid stimulating hormone (TSH) receptor-stimulating antibody (TS Ab) to TSH receptor-blocking antibody (TB Ab). Switching from dominant TS Ab activity to dominant TB Ab activity is a rare phenomenon. Optimal management of this condition is not known. Loss of follow-up and medication non-adherence has made medical management in this young woman of reproductive age further challenging. ER -