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Relapsing Graves' disease — SCE Endocrinology MCQ

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ModerateThyroidRelapsing Graves' diseaseSCE Endocrinology

A 31-year-old woman with Graves' disease has been stable on carbimazole for 16 months. TSH receptor antibody remains strongly positive and she has had two relapses after previous courses. What is the most appropriate management discussion?

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Correct answer: A — Discuss definitive therapy with radioiodine or surgery according to circumstances

Repeated relapse and persistent antibody positivity make definitive therapy a reasonable discussion. Choice between radioiodine and surgery depends on eye disease, pregnancy plans, goitre size and patient preference. Levothyroxine alone does not treat Graves' hyperthyroidism.

Reference: NICE NG145; BNF