What is recurrent Graves' disease?

Recurrent Graves’ disease is a disorder that may develop in patients who have gone into remission after a course of treatment with antithyroid drugs. A certain percentage of patients with Graves’ disease who have been treated with antithyroid drugs may spontaneously go into remission. The possibility that a patient may have gone into remission may be considered when serial thyroid function tests begin to show a progressive decline in thyroid hormone levels accompanied by a sustained increase in TSH levels. These changes may indicate that a patient's thyroid gland is no longer producing excess amounts of thyroid hormone. To determine whether a patient has entered remission, antithyroid drugs may be held so that thyroid function tests can be checked and followed. If serial thyroid function tests fail to show any evidence of persistent hyperthyroidism over the course of a full year after a patient has stopped taking antithyroid drugs, the patient may be considered to be in remission.

In some patients, remission may be sustained for long periods of time. In others it may be temporary. Up to 50% of patients who go into remission after a course of treatment with antithyroid drugs may develop recurrent hyperthyroidism within five years. If a thorough evaluation of a patient with recurrent hyperthyroidism reveals findings that are consistent with the patient’s original diagnosis, the patient may be considered to have developed recurrent Graves’ disease.

Although it is less common, some patients who have undergone apparently successful treatment with radioactive iodine or thyroid surgery may also develop recurrent Graves’ disease.