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May 16, 1977

Hypothyroidism Followed by Hyperthyroidism: Occurrence in a Patient With Elevated Antithyroid Antibody Titer

JAMA. 1977;237(20):2222. doi:10.1001/jama.1977.03270470058029

THE PROGRESSION from hypothyroidism to thyrotoxicosis, although uncommon, has been documented in the past.1 In most of these reports, the initial phase of hypothyroidism had been caused by primary thyroid failure. A similar sequence following Hashimoto thyroiditis is, indeed, rare. To our knowledge, there have been no reports of this phenomenon in the literature other than the patient described by Zellmann et al2 in 1966. In this case, a hypothyroid patient with possible Hashimoto thyroiditis became hyperthyroid two years later. Interestingly, the patient had proptosis early in the course of the illness while he was hypothyroid.

Report of a Case  A 36-year-old man had been in excellent health until 1969, when he began to feel apathetic and noted that his eyes "looked queer." The symptoms progressed until June 1970, when he was first seen by a physician who believed that he was clinically hypothyroid. The pulse was 48