Why This Study Matters

Graves’ disease is typically a bilateral autoimmune condition, but unilateral Graves’ disease (UGD) represents a rare and poorly understood variant. Its natural history remains unclear, particularly whether unilateral involvement is stable or evolves over time.

This case highlights a unique bilateral → unilateral → bilateral transition on thyroid scintigraphy, suggesting that lobar involvement in Graves’ disease may be dynamic rather than fixed . Understanding such patterns is important to avoid misinterpretation and guide appropriate clinical management.

Objectives

• Describe the clinical and imaging evolution of unilateral Graves’ disease
• Highlight variability in scintigraphic patterns over time
• Improve clinician awareness of atypical presentations
• Support better interpretation of thyroid imaging in Graves’ disease

Expected Outcomes

• Better understanding of the natural history of unilateral Graves’ disease
• Recognition that unilateral uptake may not be a fixed finding
• Improved diagnostic accuracy and follow-up strategies
• Enhanced clinical decision-making in atypical hyperthyroidism cases