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July 1978


Arch Intern Med. 1978;138(7):1174-1175. doi:10.1001/archinte.1978.03630320102041

In Reply.—  The case described by Dr Block is very interesting. However, the relevant clinical data that are necessary to document the diagnosis of painless thyroiditis of a patient with a two-year history of thyrotoxicosis are not present. Heretofore, with rare exception,1 the hyperthyroid phase of painless thyroiditis has subsided within four months of onset and usually less,1-5 a time span compatible with release of preformed thyroid hormone as the cause of the thyrotoxicosis. The duration of hyperthyroidism and response to antithyroid medication suggests that Block's case represents a different disease process. Since the timing of the radioactive iodine uptake in his patient's illness and whether the test was repeated are omitted, it is not possible to determine whether the condition has evolved into a more classic form of hyperthyroidism. Furthermore, the data that are reported are completely compatible with both ectopic thyroid hormone production and thyrotoxicosis with

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