PubMed Health⌕ Search

Biomedical subjects

G J Coombs

Publications and source records attributed to G J Coombs.

3 recordsLinked to original sources

Treatment of lymphocytic thyroiditis with spontaneously resolving hyperthyroidism (silent thyroiditis).

The duration of the hyperthyroidism associated with lymphocytic thyroiditis (LT) with spontaneously resolving hyperthyroidism (SRH) was serially monitored in groups of patients who were not given any treatment (control subjects) or treated with propylthiouracil and/or propranolol hydrochloride and prednisone. The length of time for the thyroxine tests from diagnosis to the normal range was 57 +/- 17, 45 +/- 13, and 15 +/- 7 days (mean +/- SD) indicating a dramatic response to prednisone therapy but none to propylthiouracil and/or propranolol therapy. Five patients were found who had seven episodes of SRH while receiving thyroid hormone suppression therapy after having verified chronic LT (two patients) and LT-SRH (three patients). This indicates that thyroid suppression with thyroid hormone may be ineffective in preventing this disease. Two patients were treated by subtotal thyroidectomy because of recurrent or prolonged episodes of SRH. From this experience, the therapeutic alternatives available to the clinician are reviewed.

Humans↗

Lymphocytic thyroiditis with spontaneously resolving hyperthyroidism and subacute thyroiditis. Long-term follow-up.

In a one- to 15-year follow-up of 124 patients with a history of subacute thyroiditis (SAT) without and with spontaneously resolving hyperthyroidism (SRH) (SAT and SAT-SRH, respectively), only three cases of thyroid disease probably unrelated to the original episode of thyroiditis were found. However, of the 54 patients with a history of lymphocytic thyroiditis (LT) with SRH (LT-SRH), 26 patients were found to have thyroid disease (three with hypothyroidism and 23 with goiters). Antithyroid antibodies were found to be present in 32% (8/25) of the LT-SRH group and in less than 10% (5/60) of the other three groups. The basal thyroid-stimulating hormone levels were substantially increased in the LT-SRH group only, and the response of thyroid-stimulating hormone to 200 microgram of protirelin was augmented in both SAT-SRH and LT-SRH groups. These findings demonstrate that SAT and SAT-SRH are transient thyroid disease rarely leading to permanent thyroid disease, although some loss of thyroid reserve may occur. However, LT-SRH is a persistent progressive disease similar to or the same as chronic LT, in which goiter formation and thyroid failure are a natural course.

Adolescent↗