case_images: PMC8723881_01
case_images: Thyroid course. TSH = thyroid stimulating hormone; TPO = thyroid peroxidase antibody; Tg Ab-thyroglobulin antibody; TBII = thyrotropin binding inhibitory immunoglobulin; TSI = thyroid stimulating immunoglobulins; arrow = glucocorticoid wean.
case_images: CRIPE2021-9981306.001.jpg
case_images: PMC8723881_01_CRIPE2021-9981306.001.jpg
case_images: fig1
case_images: She was started on a low dose of methimazole at this time with thyroid course and antibody status seen in Figure 1. As her glucocorticoids were weaned (arrows in Figure 1), levels of triiodothyronine rose and she required an increase in methimazole. In addition, her thyroid-stimulating immunoglobulins were initially normal but rose approximately 14 months after methimazole treatment was initiated to 394% (reference range: <140%) as shown in Figure 1.