{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T07:25:58Z","timestamp":1792135558720,"version":"4.4.0"},"reference-count":20,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T00:00:00Z","timestamp":1786406400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:p>Immune recovery after withdrawal of long-term immunosuppression may unmask autoimmune disease, but thyroid autoimmunity in patients with failed kidney allografts remains poorly characterized. We report a 29-year-old man with kidney allograft failure who developed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection after discontinuation of maintenance immunosuppression and subsequently presented with weight loss, tremor, tachycardia, diffuse goiter, and overt thyrotoxicosis. Positive thyrotropin receptor antibodies (TRAb) and diffusely increased radionuclide uptake supported a diagnosis of Graves\u2019 disease rather than destructive thyroiditis. His symptoms and thyroid function improved following treatment with methimazole, propranolol, glucocorticoids, and supportive treatment. Extracorporeal blood-purification therapies were used in the setting of persistent tachycardia, dialysis-related blood pressure fluctuations, and systemic inflammation, although their independent contribution could not be determined. Persistently elevated TRAb levels despite low peripheral B-cell counts suggested that circulating B-cell numbers did not reliably reflect humoral autoimmune activity. This case highlights a possible immune reconstitution\u2013associated form of thyroid autoimmunity after immunosuppression withdrawal and emphasizes early recognition and thyroid evaluation following new inflammatory triggers.<\/jats:p>","DOI":"10.3389\/fimmu.2026.1826575","type":"journal-article","created":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T05:40:54Z","timestamp":1786426854000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Graves\u2019 disease following immunosuppression withdrawal and SARS-CoV-2 infection in a failed kidney allograft recipient: a case report on immune reconstitution"],"prefix":"10.3389","volume":"17","author":[{"given":"Nan","family":"Yang","sequence":"first","affiliation":[{"name":"Department of Nephrology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine)","place":["Hangzhou, Zhejiang, 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