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The Abrupt Onset of Graves’ Disease: Documentation in the Setting of a Controlled Feeding Study

  • Edgar R Miller III
    Correspondence
    Correspondence should be addressed to Edgar R. Miller III, MD, PhD, Welch Center for Prevention, Epidemiology and Clinical Research, The Johns Hopkins Medical Institutions, 2024 East Monument Street, Suite 2-600, Baltimore, Maryland 21205-2223
    Affiliations
    Welch Center for Prevention, Epidemiology and Clinical Research, and the Department of Medicine (ERM), The Johns Hopkins Medical Institutions, Baltimore, Maryland, USA
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  • Lawrence J Appel
    Affiliations
    Welch Center for Prevention, Epidemiology and Clinical Research, and the Department of Medicine (ERM), The Johns Hopkins Medical Institutions, Baltimore, Maryland, USA

    Department of Epidemiology (ERM, LJA), The Johns Hopkins School of Hygiene and Public Health, Baltimore, Maryland, USA
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      The diagnosis of Graves’ disease is typically made after a patient presents with symptoms of the disease. Usual complaints are nervousness, loose stools, weakness, fatigue, unexplained weight loss, irritability or heat intolerance, often of insidious and uncertain onset (
      • Weetman A.P.
      • McGregor A.M.
      Autoimmune thyroid disease development in our understanding.
      ). However, little is known about its presymptomatic phase and whether its onset is insidious or abrupt. In this case report, we document the onset of Graves’ disease and its presymptomatic phase in the setting of a controlled feeding study. Salient features of this case include the abrupt onset of the illness and a prolonged, virtually asymptomatic phase.
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      References

        • Weetman A.P.
        • McGregor A.M.
        Autoimmune thyroid disease.
        Endocrine Rev. 1984; 5: 309-355
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