THE SEQUENTIAL OCCURRENCE OF ACUTE THYROIDITIS AND THYROTOXICOSIS
Raymond F. Sheets, M.D., Iowa CityAcute thyroiditis has become more clearly defined since it has been possible to study1 thyroid function with radioactive iodine and protein-bound iodine of the blood in addition to the usual clinical studies. For many years clinicians have suspected that some patients with thyroiditis had increased metabolism. No one has demonstrated overt thyrotoxicosis by clinical examination or laboratory findings. One explanation2 for hypermetabolism is that during the course of the thyroiditis there is some destruction of tissue, with release of thyroid hormone. This produces temporary hypermetabolism directly after thyroiditis, but it does not progress to clinical thyrotoxicosis. Nervousness, tremor, weakness, excessive perspiration, heat intolerance, and palpitation have been explained on this basis. Crile and Rumsey1a described seven patients with these symptoms. Their basal metabolic rates ranged from -8 to +28%. The patient with
CLINICAL NOTES. JAMA. 1955;157(2):139–140. doi:10.1001/jama.1955.02950190039010
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