Fire in the Gland: A Rare Case of Graves' Disease in Cystic Fibrosis
https://doi.org/10.15605/jafes.041.S1
- Author:
Mohd Deenie Mohd Rodzhan
1
;
Yik Hin Chin
2
;
Norasyikin A. Wahab
1
;
Norlaila Mustafa
1
;
Ilham Ismail
1
;
Mahrunissa Mahadi
3
Author Information
1. Department of Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia;Department of Medicine, Hospital Canselor Tuanku Muhriz
2. Department of Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia;Ministry of Health Malaysia
3. Department of Medicine, Hospital Canselor Tuanku Muhriz
- Publication Type:Journal Article
- MeSH:
Cystic Fibrosis;
Graves Disease
- From:
Journal of the ASEAN Federation of Endocrine Societies
2026;41(S1):114-115
- CountryPhilippines
- Language:English
-
Abstract:
Introduction:Cystic fibrosis (CF) is an autosomal recessive disorder
caused by mutations in the CFTR gene. Complications
such as cystic fibrosis–related diabetes (CFRD) are well
recognized. The association between CF and autoimmune
thyroid disease, however, is rare and poorly understood.
We report a case of CFRD complicated by Graves’ disease.
Case:A 22-year-old male was diagnosed with CF at age 5,
confirmed by a positive sweat chloride test. Following
the diagnosis, lifelong pancreatic enzyme replacement
therapy (Creon) was initiated to treat exocrine pancreatic
insufficiency. In 2021, he developed type 3c diabetes,
attributed to endocrine pancreatic insufficiency, and
required regular basal insulin therapy.
In early 2024, he developed hypokalemic periodic paralysis
with proximal myopathy, despite potassium correction, and
was admitted to the hospital. On admission, examination
revealed a fine tremor and diffuse bilateral neck swelling.
Biochemical evaluation showed thyrotoxicosis with Free
T4 of 37 pmol/L and thyroid-stimulating hormone (TSH)
<0.01 mIU/L. He started a tapering dose of carbimazole
and propranolol. An urgent neck ultrasound showed a
heterogeneous thyroid parenchyma with increased vascularity and no nodules. Elevated anti-thyroid peroxidase
(anti-thyroid peroxidase, >600 IU/mL) and TSH receptor
antibodies (thyrotropin receptor antibody, 2.57 IU/L)
confirmed a diagnosis of Graves’ disease. During follow-ups, he had issues with compliance with the
antithyroid therapy. However, the latest thyroid function
test in February 2026 showed Free T4 of 20.5 pmol/L with
suppressed TSH of <0.01 mIU/L. He remains clinically
euthyroid throughout the follow-up.
Conclusion:This case highlights a rare but clinically relevant coexistence. Clinicians managing symptomatic CF patients should
vigilantly screen for thyroid dysfunction to ensure early
diagnosis and timely intervention. Early recognition and
treatment may improve patient outcomes. Further research
is needed to clarify the immunological link between CF
and autoimmunity.
- Full text:202608050903012382EP_A170.pdf
