Painless Thyroiditis and Transient Thyrotoxicosis After Graves' Disease FREE

Jerome H. Check, MD; Joseph Avellino, MD

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JAMA. 1980;244(12):1361-1361. doi:10.1001/jama.1980.03310120049026

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ABSTRACT

ABSTRACT | REFERENCES

PAINLESS thyroiditis associated with transient thyrotoxicosis is a well-recognized entity and may account for 15% of all cases of thyrotoxicosis.^1,2 It is important to distinguish this condition from Graves' disease, because treatment of the two disorders is different. Because the uptake of iodine is depressed in transient thyrotoxicosis associated with thyroiditis, therapy with antithyroid medication or iodine 131 is ineffective, and since the disease is selflimited, surgery is inappropriate.³ Therefore, a radioactive iodine uptake study in newly discovered thyrotoxic patients is indicated as a means of distinguishing these two different conditions.^4,5

Graves' disease is characterized by remissions and exacerbations. However, in a patient experiencing an apparent recurrence, the radioactive iodine uptake determination should be repeated, even if the serum thyroxine (T₄) or triiodothyroxine (T₃) level is elevated, as our case illustrates.

Report of a Case The condition of a 28-year-old patient was first diagnosed as

REFERENCES

ABSTRACT | REFERENCES

Papapetrou PD, Jackson IMD: Thyrotoxicosis due to "silent" thyroiditis . Lancet 1:361-363, 1975;.

Dorfman SG, Cooperman MT, Nelson RL, et al: Painless thyroiditis and transient hyperthyroidism without goiter . Ann Intern Med 86:24-28, 1977;.

Woolf PD, Daly R: Thyrotoxicosis with painless thyroiditis . Am J Med 60:73-79, 1976;.

Gluck FB, Nusynowitz ML, Plymate S: Chronic lymphocytic thyroiditis, thyrotoxicosis, and low radioactive iodine uptake . N Engl J Med 293:624-628, 1975;.

Dorfman SG, Young RL, Nusynowitz ML: Thyroiditis and thyrotoxicosis . JAMA 240:1520-1521, 1978;.

Gardiner-Hill H: Pregnancy complicating simple goiter and Graves' disease . Lancet 1:120-124, 1929;.

Astwood EB: The use of antithyroid drugs during pregnancy . J Clin Endocrinol Metab 11:1045-1056, 1951;.

Volpé R, Johnston MW, Huber N: Thyroid function in subacute thyroiditis . J Clin Endocrinol Metab 18:65-78, 1958;.

Amino N, Kiyoshi M, Toshihide Y, et al: Transient recurrence of hyperthyroidism after delivery in Graves' disease . J Clin Endocrinol Metab 44:130-136, 1977;.

Amino N, Kiyoshi M, Ritsuko K, et al: Transient postpartum hyperthyroidism: Fourteen cases with autoimmune thyroiditis . Ann Intern Med 87:155-159, 1977;.

Amino N, Kuro R, Tanizawa 0, et al: Changes of serum anti-thyroid antibodies during and after pregnancy in autoimmune thyroid diseases . Clin Exp Immunol 31:30-37, 1978;.

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