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Thyroid function and glomerular filtration—a potential for Grave errors

2005; Oxford University Press; Volume: 20; Issue: 5 Linguagem: Inglês

10.1093/ndt/gfh708

1460-2385

Theresa Claus, Saban Elitok, Roland Schmitt, Friedrich C. Luft, Ralph Kettritz,

Thyroid Cancer Diagnosis and Treatment

A 42-year-old female was referred for polyuria. She also had observed shortness of breath, sweating, palpitations and increased appetite that was coupled with a 3 kg weight loss from her basal weight of 65 kg. Her pulse pressure and heart rate were elevated. She had minimal exophthalmos; however, Stellwag’s and Dalrymple’s signs were present. Her thyroid gland was enlarged and smooth. A systolic murmur was audible over its surface. Her hands were moist and tremulous. The muscle stretch reflexes were brisk. Hormonal studies quickly verified Graves’ disease. We were interested to find a serum creatinine concentration of 27 mmol/l with a 24 h measured creatinine clearance of 254ml/min. Of greater concern was a cystatin C concentration of 1.31mg/l. The normal concentration is 100U, while free T3 and free T4 were remarkably low. Autoantibodies consistent with Hashimoto’s thyroiditis were detected in high titres, and scintigraphy was consistent with that diagnosis.