{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T22:30:56Z","timestamp":1770330656758,"version":"3.49.0"},"reference-count":17,"publisher":"BMJ","issue":"2","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2025,2,1]]},"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:p>It is well known that radioactive iodine treatment (RAI) for thyrotoxicosis in Graves\u2019 disease can precipitate worsening of thyroid eye disease (TED), particularly in susceptible patients. Less commonly, it has been associated with <jats:italic>de novo<\/jats:italic> development of TED in those with Graves\u2019 disease without a history. Prophylactic steroid treatment has been shown to reduce the incidence of this phenomenon in those with risk factors.<\/jats:p>\n               <jats:p>Here, we describe a patient with thyrotoxicosis due to nodular thyroid disease rather than Graves\u2019 disease and normal baseline thyroid-stimulating hormone receptor antibody (TRAb) levels and no other risk factors for TED, who subsequently developed new onset TED associated with thyrotoxicosis and elevated TRAb levels following RAI.<\/jats:p>","DOI":"10.1136\/bcr-2024-263986","type":"journal-article","created":{"date-parts":[[2025,2,11]],"date-time":"2025-02-11T12:47:22Z","timestamp":1739278042000},"page":"e263986","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["De novo Graves\u2019 thyroid eye disease after radioiodine treatment for toxic nodular thyroid disease"],"prefix":"10.1136","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7032-1238","authenticated-orcid":false,"given":"Adhithya","family":"Sankar","sequence":"first","affiliation":[{"name":"Manchester University NHS Foundation Trust, Manchester, UK"},{"name":"Royal Albert Edward Infirmary, Wigan, Wigan, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rashmita","family":"Singh","sequence":"additional","affiliation":[{"name":"Royal Albert Edward Infirmary, Wigan, Wigan, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sushmita","family":"Pearce","sequence":"additional","affiliation":[{"name":"Royal Albert Edward Infirmary, Wigan, Wigan, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,2,11]]},"reference":[{"key":"2025082803455398000_18.2.e263986.1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)00278-6"},{"key":"2025082803455398000_18.2.e263986.2","doi-asserted-by":"crossref","DOI":"10.3389\/fendo.2020.615993","article-title":"Epidemiology, Natural History, Risk Factors, and Prevention of Graves\u2019 Orbitopathy","volume":"11","author":"Bartalena","year":"2020","journal-title":"Front Endocrinol (Lausanne)"},{"key":"2025082803455398000_18.2.e263986.3","doi-asserted-by":"crossref","DOI":"10.1186\/s40662-014-0009-8","article-title":"An overview of thyroid eye disease","volume":"1","author":"McAlinden","year":"2014","journal-title":"Eye Vis (Lond)"},{"key":"2025082803455398000_18.2.e263986.4","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2010.1634"},{"key":"2025082803455398000_18.2.e263986.5","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199801083380201"},{"key":"2025082803455398000_18.2.e263986.6","unstructured":"National Institute for Health and Care Excellence . Thyroid disease: assessment and management [NG145]. 2023. Available: https:\/\/www.nice.org.uk\/guidance\/ng145 [Accessed 10 Aug 2024]."},{"key":"2025082803455398000_18.2.e263986.7","doi-asserted-by":"crossref","first-page":"803","DOI":"10.1111\/j.1365-2265.1994.tb02516.x","article-title":"Appearance of thyroid stimulating antibody and Graves\u2019 disease after radioiodine therapy for toxic nodular goitre","volume":"40","author":"Chiovato","year":"1994","journal-title":"Clin Endocrinol (Oxf)"},{"key":"2025082803455398000_18.2.e263986.8","doi-asserted-by":"crossref","unstructured":"Olaremi J . Iatrogenic Graves\u2019 disease - A case of severe Graves\u2019 disease and Graves\u2019 orbitopathy occuring after radioiodine therapy for toxic nodular goitre. 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COVID-19 and thyroid function: What do we know so far? 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