Endocrine Abstracts

Introduction: Stress is a known risk factor for the development of Graves’ disease. We have previously described the role of bereavement as an inducing factor for Graves’ disease. Bereavement as an inducing factor for Graves’ disease was shown to affect primarily female patients after the loss of a loved one. However, it appears that other stressful life events may also cause Graves’ disease.

Aim: The aim of the study was to describe two cases of patients developing Graves’ disease after job related events.

Case reports: A male patient, aged 42, presented with hyperthyroidism and Graves’ ophthalmopathy affecting both eyes. The patient had also severe pretibial myxedema. Within the previous month he had lost a good job and had suffered the subsequent financial loss. He had also experienced fraud from a job partner. The patient was treated with methimazole and corticosteroids for Graves’ ophthalmopathy. Hyperthyroidism improved. Pretibial myxedema also improved. Graves’ ophthalmopathy stabilized. However, two years later the patient suffered a relapse of hyperthyroidism. The patient had a family history of Graves’ disease from the maternal side. A female patient, aged 56, presented with hyperthyroidism and mild Graves’ ophthalmopathy affecting both eyes. The patient had suffered a job loss within the previous two months. She was treated with methimazole and hyperthyroidism improved. The patient had a family history of Graves’ disease from the maternal side.

Conclusions: It appears that stressful life events such as a job loss with severe financial impact may be followed by disease, in particular, an autoimmune thyroid disease, such as Graves’. Bereavement has been previously described to induce Graves’ disease. However, in this report we show that stressful life events related to financial loss may also be an inducing factor for Graves’.