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January 1978

Typical and Atypical ('Silent') Subacute Thyroiditis in a Wife and Husband

Author Affiliations

From the Department of Internal Medicine, Gundersen Clinic, Ltd, and the La Crosse Lutheran Hospital, Wisconsin. Dr Morrison is now at the Bemidji Clinic, Bemidji, Minn.

Arch Intern Med. 1978;138(1):45-48. doi:10.1001/archinte.1978.03630250029012

Typical subacute thyroiditis was diagnosed in a woman. Three weeks later, signs and symptoms of hyperthyroidism developed in her husband. Although the right lobe of his thyroid gland was slightly enlarged, pain and tenderness were absent throughout the course of his illness. The free thyroxine equivalent (FTE) value and the sedimentation rate were elevated; the low uptake of radioactive iodine by the thyroid gland was consistent with "silent" subacute thyroiditis. We postulate that a common etiology, probably viral, was operative in both cases.

Nine additional cases of hyperthyroidism with low levels of thyroidal uptake of radioactive iodine are described. The thyroid glands of these patients were normal or slightly enlarged. Antithyroglobulin antibody levels determined in seven patients were not substantially elevated. The clinical course of these patients was characteristic of "silent" subacute thyroiditis. Although the origin of the syndrome remains unclear, the disease is self-limited and therapy, if any, is supportive.

(Arch Intern Med 138:45-48, 1978)