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June 1978

'Silent' Subacute Thyroiditis

Author Affiliations

Phoenix, Ariz

Arch Intern Med. 1978;138(6):1024-1025. doi:10.1001/archinte.1978.03630310098040

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To the Editor.—  Morrison and Caplan's recent article in the January Archives (138:45-48, 1978), which concerned typical and atypical subacute thyroiditis, contains, in a concluding paragraph, the statement, "We emphasize that the disorder is benign and self-limited... and propranolol hydrochloride is the only treatment, if any, that is necessary."We would like to take exception to this statement for we have been observing a patient who fulfills the criteria of atypical silent subacute thyroiditis and who has remained hyperthyroid for over two years. Inasmuch as she has demonstrated the effects of continued unabated thyroid hormone secretion, we felt obligated to treat her and have used thiourea therapy. Peripheral thyroid hormone levels have returned to normal with this treatment. We therefore question whether conservative management of these patients, with propranolol therapy only, is indicated. Perhaps our patient is an unusual example of this condition, but patients have already been described who

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