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      Autoimmune Thyroiditis with Transient Thyrotoxicosis: Comparison between Painful Thyroiditis and Painless Thyroiditis

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          Abstract

          Clinical and laboratory findings and long-term outcomes in 8 patients (7 women) with autoimmune thyroiditis (AT), aged 34–59 years, who had a painful tender goiter and a transient thyrotoxicosis with a low thyroid radioactive iodine uptake (RAIU), were compared with those in 15 patients (13 women) with painless thyroiditis (PT), aged 23–69 years. Six painful AT and 6 PT patients had a history of prior awareness of goiter. All patients with painful AT had a moderate or marked elevation of erythrocyte sedimentation rate and a positive result for C-reactive protein, while only 3 PT patients (group B) did. There were no significant differences between the mean age, duration of symptoms, white blood cell count, serum triiodothyronine (T<sub>3</sub>) and thyroxine (T<sub>4</sub>) concentrations, serum T3/T4 ratio and duration of thyrotoxicosis after the initial examination and prevalences of positive results for antithyroglobulin and -microsomal antibodies in the two diseases. Two of 8 painful AT patients showed a histologically chronic fibrous variant and 6 others showed chronic lymphocytic thyroiditis. All PT patients examined also showed lymphocytic thyroiditis. Two and 5 painful AT patients developed transient and persistent hypothyroidism, respectively, while 8 [7 in group A (normal ESR), 1 in group B] and 3 PT patients (1 in group A, 2 in group B) did, respectively. The mean serum thyroid-stimulating hormone level in the hypothyroid phase in painful AT patients was higher than that in PT patients. Thus, on the basis of AT, acute exacerbations of the immune aggression against the thyroid may occur which lead to transient thyrotoxicosis with a low RAIU and, according to the degree of immune phenomena, either to a painful or to a painless thyroid swelling.

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          Author and article information

          Journal
          HRE
          Horm Res Paediatr
          10.1159/issn.1663-2818
          Hormone Research in Paediatrics
          S. Karger AG
          1663-2818
          1663-2826
          1991
          1991
          02 December 2008
          : 36
          : 1-2
          : 9-15
          Affiliations
          First Department of Internal Medicine, Tottori University School of Medicine, Yonago, Japan
          Article
          182098 Horm Res 1991;36:9–15
          10.1159/000182098
          1814808
          © 1991 S. Karger AG, Basel

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          Page count
          Pages: 7
          Categories
          Original Paper

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