Coexistence of Thyroid Tuberculosis and Graves Disease

A 42 years old woman without any special pathological history who has shown signs of a serious hyperthyroidism with bilateral exophthalmia during two months. The clinical examination revealed a tachycardia at 120batt/min and the cervical palpation showed a homogeneous goitre characterized by an elastic consistency and a very clear vascular character. The biological balance noted a braked TSHus <0.005mUI/L NR: (0.27-4.2mU/L), a T4 at 98pmol/l NR: (12-22pmol/l), and a T3 at 54pmol/l NR: (3.2-6pmol/l). The Cervical ultrasound shows a homogeneous hypo-echogenic thyroid that is highly vascularized on doppler. The diagnosis of Graves disease was confirmed by the high level of antibody antiTSH 76NR: (<2mUI/ml). At last, it is to notice that the electrocardiogram and blood count were normal.