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April 1980

Management of Thyrotoxicosis With a Low Radioactive Iodine Uptake

Arch Intern Med. 1980;140(4):469. doi:10.1001/archinte.1980.00330160029017

In their article entitled "Lymphocytic Thyroiditis with Spontaneously Resolving Hyperthyroidism (Silent Thyroiditis)" in this issue (see p 478), Nikolai et al strongly and appropriately emphasize the need for radioactive iodine uptake (RAIU) as the key study to aid the clinician in diagnosing this syndrome, after biochemically confirming thyrotoxicosis. They have also found that the ESR was seldom above 50 mm/hr and was frequently in the normal range in patients with this disorder. Patients with symptomatic, acute, nonsuppurative thyroiditis (subacute or granulomatous thyroiditis) usually have an ESR in excess of 50 mm/hr. The authors also report the usefulness of the needle biopsy for confirming the diagnosis of this syndrome.

Since the time for resolution of the disorder is usually one to three months after clinical appearance, and seldom as long as five months, only occasionally is it necessary to perform additional studies such as thyroid-stimulating hormone (TSH) stimulation test or a