Thyroid hemiagenesis with Graves’ disease: The first reported case in Lebanon

Abstract

Background: Thyroid hemiagenesis (TH) is a rare disorder that is usually clinically silent unless associated with other thyroidal pathologies. We present a case of a TH patient with Graves’ disease (GD). To our knowledge, this is the first ever case to be reported in Lebanon, and worldwide since 2017. Case report: A 45-years-old woman with GD was investigated for persistent anxiety and tremors. Radiological imaging disclosed the absence of the left thyroid lobe on neck ultrasound along with increased tracer uptake by the right lobe on the thyroid scan, in keeping with toxic right hemithyroid. This is an extremely rare case of thyroid hemiagenesis associated with Graves’ disease (THGD). Discussion: Clinical examination can help in the diagnosis of TH with the palpation of one thyroid lobe in the presence or absence of an isthmus. However to diagnose THGD, workup requires biochemical testing along with imaging and scintigraphy to complement the findings of GD in the present lobe. Follow-up visits are very important to make sure that the treatment of choice has been effective and that there has not been any relapse. Conclusion: THGD is a rare form of thyroid disorders that can be misdiagnosed sometimes. The actual pathophysiology of the disease is still unknown.

Keywords

• Thyroid hemiagenesis
• Graves' disease
• Methimazole
• Lebanon