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Painless Thyroiditis and Transient Hyperthyroidism Without Goiter

STEVEN G. DORFMAN, M.D.; MICHAEL T. COOPERMAN, M.D.; ROGER L. NELSON, M.D.; HARSTRY DEPUY, Ph.D.; ROBERT L. PEAKE, M.D., F.A.C.P.; and ROBERT L. YOUNG, M.D., F.A.C.P.
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▸Requests for reprints should be addressed to Steven G. Dorfman, M.D.; Endocrinology Service (SGHME), Wilford Hall USAF Medical Center; Lackland AFB, San Antonio, TX 78236.


San Antonio, Texas


Ann Intern Med. 1977;86(1):24-28. doi:10.7326/0003-4819-86-1-24
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Eight women had painless thyroiditis, transient thyrotoxicosis, and low radioactive iodine uptakes but were without goiter; they constituted 15% of all thyrotoxicosis cases that we saw during the past year. Standard antithyroid antibody tests by tanned erythrocyte hemagglutination, complement fixation, and colloid and microsomal fluorescence, if present initially, were only weakly positive and became negative by 9 months. However, human antithyroglobulin antibody levels by a sensitive radioimmunoassay were elevated initially in all patients. In general, these radioimmunoassayable antibody levels fell, but they had not returned to normal by 9 months. Serial thyroid function tests and standard antithyroid antibody tests were most compatible with subacute thyroiditis. However, the persistence of radioimmunoassayable antithyroglobulin antibodies and recent reports of histologic evidence of lymphocyte thyroiditis in similar patients with goiter leaves open the possibility that this is a previously unrecognized presentation of chronic lymphocytic thyroiditis. Neither the cause nor the ultimate course of this syndrome is known.

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