Asymptomatic thyroiditis; a few typical cases and the prevalence of this disease

Although asymptomatic thyroiditis (АГ) is well known by the present time, the prevalence of this disease is still disputed. We evaluated the incidence of A T at Thyroidology Department of Omori Hospital. Asymptomatic thyroiditis was detected in 61 out of 1113 patients (5.5%) during the period of July 1993 to June 1996. On admission, high levels of free thyroxin in the blood (hyperthyroxinemia) were detected in 306 patients. Asymptomatic thyroiditis was the cause of this condition in 38 (12.4%) patients. By the moment of examination of patients with A T, thyrotoxicosis was revealed in 38 patients, euthyroid status in 17, and hypothyrosis in 6 patients. Patients with euor hypothyrosis had complaints and presented with clinical signs of thyrotoxicosis 1-2 months before examination. Antibodies to thyroperoxidase and/or thyroglobulin were detected in 51 out of 61 (84%) patients with A T. Sometimes A T is regarded as diffuse toxic goiter (DTG), but a patient with this condition can develop A T. We should always remember about the possibility of AT but not DTG even in cases with pronounced thyrotoxicosis or with a history of DTG. Regular check-ups of thyroid function will help diagnose the condition without resorting to ¹²²1. If a patient has symptoms of thyrotoxicosis, e. g. palpitation, thyroid function should be examined.

Неге аге 4 typical cases with AT to illustrate this. Patient No. 1 is a classical case of Hashimoto’s thyroiditis. Previously she developed an euthyroid status, and later thyroid destruction and dysfunction (transitory thyrotoxicosis followed by hypothyrosis) developed spontaneously without pregnancies or deliveries. Patient No. 2 had transitory thyrotoxicosis which was not followed by hypothyrosis, but with a transitory slight increase in TTH. She might have had AT3years before. Patient No. 3 aged 63years complained of angina pectoris and arrhythmia; later she was prescribed substitute therapy with L thyroxin for pronounced hypothyrosis (TTH 90.9 microunits/ml). In patient No. 4 DTG was erroneously diagnosed and she was prescribed therapy for this condition. Thyroid dysfunction was transitory in all patients, and the function recovered later.