Abstract • A 68-year-old woman with Sjögren's syndrome simultaneously experienced thyrotoxicosis with a marked depression of thyroid radioactive iodine uptake and systemic lupus erythematosus—like symptoms, which both resolved spontaneously. Titers of antinuclear antibody and anti-DNA antibody were most elevated when the thyrotoxicosis and systemic lupus erythematosus—like symptoms coexisted and thereafter gradually declined in response to the decrease of titers of antithyroglobulin hemagglutination antibody and antimicrosomal hemagglutination antibody. To our knowledge, no such case has been previously reported. These observations strongly suggest that thyrotoxicosis In silent thyroiditis may be induced by an autoimmune mechanism. (Arch Intern Med 1988;148:1974-1975) References 1. Amino N, Kuro R, Tanizawa F, et al: Changes of serum antithyroid antibodies during and after pregnancy in autoimmune thyroid disease. Clin Exp Immunol 1978;31:36-37. 2. Amino N, Miyai K, Kuro R, et al: Transient postpartum hypothyroidism: Fourteen cases with autoimmune thyroiditis. Ann Intern Med 1977;87:155-159.Crossref 3. Amino N, Miyai K, Onishi T, et al: Transient hypothyroidism after delivery in autoimmune thyroiditis. J Clin Endocrinol Metab 1976;42:296-301.Crossref 4. Gluck FB, Nusynowitz MD, Polymate S: Chronic lymphocytic thyroiditis, thyrotoxicosis and low radioactive iodine uptake: Report of four cases. N Engl J Med 1975;293:624-628.Crossref 5. Gorman CA, Durick DS, Woolner JB, et al: Transient hyperthyroidism in patients with lymphocytic thyroiditis. Mayo Clin Proc 1978;53:359-365. 6. Nikolai TF, Brosseau J, Kettrick MA, et al: Lymphocytic thyroiditis with spontaneously resolving hyperthyroidism (silent thyroiditis). Arch Intern Med 1980;140:478-482.Crossref 7. Woolf PD: Transient painless thyroiditis with hyperthyroidism: A variant of lymphocytic thyroiditis? Endocrinol Rev 1980;1:411-420.Crossref 8. Fein HG, Golman JM, Weintraub BD: Postpartum lymphocytic thyroiditis in American women: A spectrum of thyroid dysfunction. Am J Obstet Gynecol 1980;138:504-510. 9. Maruyama H, Kato M, Mizuno O, et al: Transient thyrotoxicosis occurred after cessation of steroid therapy in a patient with autoimmune thyroiditis and rheumatoid arthritis. Endocrinol Jpn 1982;29:583-588.Crossref 10. Tajiri J, Higashi K, Morita M, et al: Elevation of anti-DNA antibody titer during thyrotoxic phase of silent thyroiditis. Arch Intern Med 1986;146:1623-1624.Crossref
Archives of Internal Medicine – American Medical Association
Published: Sep 1, 1988
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