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Endocrine Abstracts (2015) 37 EP929 | DOI: 10.1530/endoabs.37.EP929

1Department of Endocrinology, Charles Nicolle University Hospital, Tunis, Tunisia; 2Department of Nephrology, Charles Nicolle University Hospital, Tunis, Tunisia.

Introduction: Renal complications in Graves’ disease are rare and may be related either to the disease itself or secondary to antithyroid drugs.

Methods: We report seven cases of renal damage in patients with Graves’ disease treated with Benzylthiouracyl collected over a period of 14 years.

Results: There were seven women with a mean age of 37.86±14.25 years (19–61 years).

Six patients developed renal vasculitis associated with ANCA. The signs were dominated by renal proteinuria and renal failure noted in all cases and associated with hematuria in five cases. The lung involvement was the most common extrarenal manifestation occurred in four patients (alveolar hemorrhage in two cases, lymphocytic alveolitis in one case and pleurisy in 1 case). The benzylthiouracyl was discontinued in four patients still under treatment. Corticosteroid therapy was used alone or in combination with cyclophosphamide in all cases. Plasmapheresis sessions were made during the alveolar hemorrhage. A complete remission was obtained in one case and incomplete remission in two cases. The other three patients required chronic hemodialysis. One patient died of sepsis. The seventh patient developed a nephrotic syndrome with hypertension and hematuria related to membranous glomerulonephritis. In this patient, the etiology was not found. Complete remission of nephrotic syndrome was achieved with corticosteroids.

Conclusion: The possibility of renal impairment in Graves’ disease requires monitoring to detect urinary abnormalities in order to early initiate therapy and improve patient’s outcome.

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