THYROID ACROPACHY: A RARE MANIFESTATION OF GRAVES DISEASE IN JOINTS.

THYROID ACROPACHY: A RARE MANIFESTATION OF GRAVES DISEASE IN JOINTS.:

Related Articles

THYROID ACROPACHY: A RARE MANIFESTATION OF GRAVES DISEASE IN JOINTS.

AACE Clin Case Rep. 2019 Nov-Dec;5(6):e369-e371

Authors: Perini N, Santos RB, Romaldini JH, Villagelin D

Abstract

Objective: The objective of this report was to describe a patient with Graves acropachy, a rare manifestation of Graves disease (GD) that is clinically defined by skin tightness, digital clubbing, small-joint pain, and soft tissue edema progressing over months or years with gradual curving and enlargement of the fingers.

Methods: The patient was evaluated regarding thyroid function (serum free T4 [FT4] and thyroid-stimulating hormone [TSH] quantifications) and autoimmunity biomarkers (thyroid receptor antibody [TRAb]) as well as radiographic investigation of the extremities.

Results: A 52-year-old man presented with a history of thyrotoxicosis and clinical signs of Graves orbitopathy. Laboratory tests showed suppressed TSH (0.01 UI/L; normal, 0.4 to 4.5 UI/L) and elevated serum FT4 (7.77 ng/dL; normal, 0.93 to 1.7 ng/dL), with high TRAb levels (40 UI/L; normal, <1.75 UI/L). A diagnosis of thyrotoxicosis due to GD was made and the patient was treated with methimazole. After the patient complained of swelling in hands and feet, X-ray evaluation was conducted and established the thyroid acropachy.

Conclusion: We present a case of a patient with GD associated with worsening extrathyroid manifestations during orbitopathy, dermopathy, and developed acropachy in hands and feet.

PMID: 31967073 [PubMed]