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Treating Lymphocytic Thyroiditis With Spontaneously Resolving Hyperthyroidism-Reply

Steven Dorfman, MD; Richard Sachson, MD; Stanley Feld, MD
Arch Intern Med. 1983;143(4):844-845. doi:10.1001/archinte.1983.00350040234048.
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In Reply.  —Dr Compagno's criticism of our editorial is somewhat valid. Clearly, only when a tissue diagnosis is established, can one be absolutely certain that the diagnosis is lymphocytic thyroiditis with SRH. It is also true that a fine needle aspiration of the thyroid is a relatively innocuous procedure. However, several comments need to be made to defend our statement.First, most internists are not well-versed in doing thyroid biopsies and most pathologists cannot readily interpret the fine needle-aspiration cytologic specimens. Second, there are patients with SRH who are not seen with a goiter and, therefore, would not be ideal candidates for thyroid biopsy. Moreover, the most valid reason for not routinely doing thyroid biopsies is that the diagnosis can readily be established on clinical grounds.1 Only in unusual circumstances, when one cannot accomplish a 24-hour radioactive iodine uptake, should a thyroid biopsy be considered. Such a circumstance would


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