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'Silent' Subacute Thyroiditis-Reply

Robert H. Caplan, MD; John Morrison, MD
Arch Intern Med. 1978;138(6):1025. doi:10.1001/archinte.1978.03630310098041.
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In Reply.—  Recently, investigators have reported 39 cases of hyperthyroidism without thyroid pain and/or tenderness associated with low radioactive iodine uptake (RAIU). Gluck and associates1 have made a valuable contribution to the understanding of the cause of this syndrome by noting histological changes of chronic thyroiditis on thyroid biopsies performed in four cases. Although the changes of chronic thyroiditis have also been detected by other investigators,2,3 there remains considerable controversy over whether patients with this thyroid disorder have a form of subacute thyroiditis or chronic thyroiditis. In an editorial in the January Archives (138:26-27, 1978), Woolf indicates that patients exhibit features of both disorders. The clinical course, low RAIU, and negative or weakly positive thyroid antibodies suggests subacute thyroiditis, while the absence of thyroidal pain, normal ESR and biopsy findings are consistent with chronic thyroiditis. Although the relative merits of these causes are debated in recent reports, editorials,


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