抄録
We report on six cases of anorexia nervosa associated with Graves' disease. The relationship between the two diseases and the pathogenesis of anorexia nervosa are considered.Case 1 was an 18-year-old female, one of monozygotic twins : Both twins suffered from Graves' disease and underwent thyroidectomy at the same time. Six months after the operation, one of them developed anorexia nervosa. From this case, it would seem that the hereditary factor is more important in Graves' disease but it does not play a main role in anorexia nervosa. We observed five cases of twins only one of each set of twins was suffering from anorexia nervosa.Case 2 was a 13-year-old female. At first she suffered from Graves' disease. During her recuperation her body weight increased in spite of a normal diet. She showed a fear of becoming obese, and started to reduce her intake of food.Case 3 was a 25-year-old female who followed a similar clinical course as case 2.Case 4 was a 25-year-old female. Anorexia was associated with a stressful life situation after marriage. One year after the onset of anorexia, her condition was diagnosed as Graves' disease. In spite of a high level of serum thyroid hormone, she did not show the syndrome of hyperthyroidism. The hypermetabolic state of Graves' disease seemed to be suppreassed by the hypometabolism occasioned by anorexia.Case 5 was a 19-year-old female who suffered from both anorexia nervosa and Graves' disease at the same time. She showed a tendency toward low T_3 syndrome in spite of her hyperthyroidism.Case 6 was a 20-year-old female. Due to anorexia her body weight once decreased from 55kg to 35.2kg. After a turn from anorexia to bulimia, her body weight increased to 80kg, in spite of an association with the hypermetabolic state of Graves' disease.From the above cases, it is concluded that the hereditary factor does not necessarily play a main role in anorexia nervosa, and the increased body weight during recuperation of Graves' disease is a trigger cause of anorexia. Further, the clinical picture of Graves' disease is usually hidden by the clinical symptom of anorexia nervosa.
