{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T12:05:37Z","timestamp":1773144337907,"version":"3.50.1"},"reference-count":11,"publisher":"BMJ","issue":"4","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2019,3,14]]},"published-print":{"date-parts":[[2019,4]]},"abstract":"<jats:p>We report two women who were diagnosed with hypothyroidism due to what was thought to be Hashimoto\u2019s thyroiditis 18 and 16 years ago, respectively. They had been euthyroid on stable doses of levothyroxine for many years, and they presented to our clinic with clinically and biochemically overt hyperthyroidism that persisted even after stopping levothyroxine. Immunological and imaging workups were consistent with Graves\u2019 disease. Both patients were treated medically and then received definitive treatment. To our knowledge, the intervals for these two conversions are among the longest conversion intervals reported in the medical literature.<\/jats:p>","DOI":"10.1136\/bcr-2018-227445","type":"journal-article","created":{"date-parts":[[2019,4,6]],"date-time":"2019-04-06T07:15:38Z","timestamp":1554534938000},"page":"e227445","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":8,"title":["Hypothyroidism to hyperthyroidism: an immunological pendulum swing from two extreme poles \u2013 a case series"],"prefix":"10.1136","volume":"12","author":[{"given":"Antoni R","family":"Kafrouni Gerges","sequence":"first","affiliation":[{"name":"Department of Endocrinology, Albany Medical Center Hospital, Albany, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sara N","family":"Clark","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Albany Medical Center Hospital, Albany, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hassan","family":"Shawa","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Albany Medical Center Hospital, Albany, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2019,4,5]]},"reference":[{"key":"2025082622553231000_12.4.e227445.1","doi-asserted-by":"publisher","DOI":"10.1210\/jcem-61-6-1172"},{"key":"2025082622553231000_12.4.e227445.2","article-title":"Thyrotoxicosis developing in recurrent nodular goitre with focal thyroiditis","volume":"52","author":"JOPLIN","year":"1959","journal-title":"Proc R Soc Med"},{"key":"2025082622553231000_12.4.e227445.3","doi-asserted-by":"publisher","DOI":"10.2169\/internalmedicine.45.1506"},{"key":"2025082622553231000_12.4.e227445.4","article-title":"Hypothyroidism conversion to hyperthyroidism: it\u2019s never too late","volume":"2018","author":"Ahmad","year":"2018","journal-title":"Endocrinol Diabetes Metab Case Rep"},{"key":"2025082622553231000_12.4.e227445.5","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2265.1987.tb00791.x"},{"key":"2025082622553231000_12.4.e227445.6","doi-asserted-by":"publisher","DOI":"10.1210\/jcem-46-5-734"},{"key":"2025082622553231000_12.4.e227445.7","doi-asserted-by":"crossref","first-page":"609","DOI":"10.20945\/2359-3997000000086","article-title":"Conversion to graves disease from hashimoto thyroiditis: a study of 24 patients","volume":"62","author":"Gonzalez-Aguilera","year":"2018","journal-title":"Arch Endocrinol Metab"},{"key":"2025082622553231000_12.4.e227445.8","doi-asserted-by":"crossref","first-page":"744","DOI":"10.1089\/thy.2013.0452","article-title":"In young patients with turner or down syndrome, graves' disease presentation is often preceded by hashimoto\u2019s thyroiditis","volume":"24","author":"Aversa","year":"2014","journal-title":"Thyroid"},{"key":"2025082622553231000_12.4.e227445.9","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2265.1988.tb03664.x"},{"key":"2025082622553231000_12.4.e227445.10","doi-asserted-by":"crossref","DOI":"10.3402\/jchimp.v4.25734","article-title":"Oscillating hypothyroidism and hyperthyroidism - a case-based review","volume":"4","author":"Fan","year":"2014","journal-title":"J Community Hosp Intern Med Perspect"},{"key":"2025082622553231000_12.4.e227445.11","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2012.0374"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2018-227445","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T05:55:39Z","timestamp":1756274139000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2018-227445"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,4]]},"references-count":11,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2019,4,5]]},"published-print":{"date-parts":[[2019,4]]}},"alternative-id":["10.1136\/bcr-2018-227445"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2018-227445","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,4]]}}}