A 67-year-old @entity1 was referred to our department for @entity2743 with intermittent palpitation and 4-kg weight loss during the previous month. At the first visit, the @entity1 was treated with @entity205 ( @entity9472 ) for @entity8 during the last 3 years and 8 months. Laboratory studies revealed that the serum TSH level was <0.005 U/ml, and free @entity1955 (fT4) and @entity1954 (fT3) levels were elevated at 2.76ng/dl and 5.96pg/ml respectively. Anti-TSH receptor antibody (TRAb) level was increased at 26.4%. A clinical diagnosis of Graves' @entity1378 was given, and then thyrostatic treatment with @entity3937 ( @entity3936 ) at a dose of 10mg daily was initiated after @entity9472 withdrawal. After the initiation of @entity3936 therapy, serum fT4 and fT3 attained the normal level within 1.5 months, with relief of symptoms followed by a remarkable decrease in urinary protein excretion from 2.0-5.2g/day to  <=0.03g/day. The @entity1 maintained euthyroid with a low titre of TRAb for the succeeding 2 years and then @entity3936 was finally stopped. Neither a relapse of @entity1378 nor a flare-up of @entity1985 was observed for 3 years after @entity3936 discontinuation. @entity9472 has conflicting effects on immunologic self-tolerance by modulation of self-reactive T cells and natural @entity404 (+)CD25(+)Foxp3(+) regulatory T cell (Treg) functions, and possibly becomes a triggering factor in the development of @entity792 . This case may be interesting when considering the effect of each T cell subset on the development of @entity2743 . LEARNING POINTS: The balance between intrathyroidal self-reactive T cell and natural @entity404 (+)CD25(+)Foxp3(+) Treg functions determine self-tolerance in the thyroid. @entity9472 not only halts the expansion of self-reactive T cells but also impairs the function of Treg, which can provoke an unwanted immune response.A change in thyroid autoimmunity during treatment with @entity9472 may result in the development of @entity1669 ( @entity1669 ).Renal involvement in @entity1669 frequently manifests as @entity1985 , and thyrostatic treatment with @entity3937 may be effective for excessive @entity644 .

Onset of XXXX during long-term immunosuppressive therapy in a @entity1 with @entity8 .

@entity1 :: ('9606', 'Species') :: ['patient', 'man'] @entity9472 :: ('D016572', 'Chemical') :: ['CyA'] @entity8 :: ('MESH:D007674', 'Disease') :: ['membranous nephropathy'] @entity644 :: ('MESH:D011507', 'Disease') :: ['proteinuria'] @entity404 :: ('920', 'Gene') :: ['CD4'] @entity3937 :: ('MESH:D008713', 'Chemical') :: ['thiamazole'] @entity2743 :: ('MESH:D006111', 'Disease') :: ["Graves' disease", 'thyrotoxicosis'] @entity1669 :: ('MESH:D013967', 'Disease') :: ['autoimmune thyroid diseases', 'AITD'] @entity1955 :: ('MESH:D013974', 'Chemical') :: ['thyroxine'] @entity1378 :: ('MESH:D006980', 'Disease') :: ['hyperthyroidism'] @entity205 :: ('MESH:D016572', 'Chemical') :: ['cyclosporine A'] @entity1985 :: ('MESH:D009404', 'Disease') :: ['nephrotic syndrome'] @entity3936 :: ('CHEBI:55312', 'Chemical') :: ['MMI'] @entity792 :: ('MESH:D001327', 'Disease') :: ['autoimmune disorders'] @entity1954 :: ('MESH:D014284', 'Chemical') :: ['triiodothyronine']
@entity2743 :: (MESH:D006111,Disease) :: ['Graves' disease']
