We describe a case of worsening Gravesâ?? orbitopathy due to immune reconstitution inflammatory syndrome (IRIS) in a 38-yearold\nHIV-infected male after beginning ART (antiretroviral therapy). Two years after initiation of ART, the patient developed\nsymptoms of hyperthyroidism and thyroid eye disease (TED) or Gravesâ?? orbitopathy (GO). Thyroid iodine uptake scan was\nconsistent with Gravesâ?? disease. The CT scan of the orbits revealed minimal right-sided proptosis, consistent with GO. He was\ntreated with methimazole and a short course of high-dose prednisone for GO. Thyroid function tests normalized, and eye\nsymptoms eventually stabilized. This case demonstrates the importance of awareness and early recognition of IRIS in its many\nforms, as it has significant therapeutic implications.
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