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February 20, 1967

Recurrent Hyperthyroidism After Normal Response To Liothyronine

JAMA. 1967;199(8):588. doi:10.1001/jama.1967.03120080122031

To the Editor:—  Long-term remissions occur in approximately 50% of patients with Graves' disease after discontinuation of protracted antithyroid drug treatment.1 Criteria that can be used to distinguish patients whose remissions will be maintained from those who will have relapses are of clinical importance and theoretical interest. Recently, it has been observed that after treatment with antithyroid drugs some patients with Graves disease exhibit reduction in their thyroid radioactive iodine uptakes following administration of exogenous thyroid2 or liothyronine triiodothyronine, T-3.3 These patients tend to remain euthyroid during the period of follow-up. In contrast, patients who fail to show suppression of iodine uptakes have a high incidence of recurrence of hyperthyroidism. Therefore, testing with exogenous thyroid or liothyronine may be of considerable prognostic value.The present study reports the first case of recrudesence of hyperthyroidism in a euthyroid patient with Graves' disease shortly after a normal response to