Hyperthyroidism in Association with Ulcerative Colitis : A Case Report

This report describes a case of hyperthyroidism associated with ulcerative colitis (UC). A 47-year-old woman who received a subtotal colectomy for incurable UC was admitted to our hospital to undergo a pouch operation. On admission, palpitation, hypersweating, and a finger tremor were observed, and laboratory examination revealed increases of serum free T3 and free T4 along with the positive thyroid stimulating hormone (TSH) receptor antibody. A diagnosis of Graves' disease was confirmed, and after normalization of the thyroid function by potassium iodide and thiamazole, a remnant total colectomy and ileal pouch-anal anastomosis were performed. The postoperative course was uneventful and the patient is in good condition two years on, showing no symptoms of hyperthyroidism. Association of UC and hyperthyroidism is rare; however, the perioperative condition of a patient with UC might deteriorate without the proper management of hyperthyroidism. Thus, surgeons must be alert to the possible coexistence.