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Hypothyroidism and Thyroiditis

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Challenging Cases in Endocrinology

Part of the book series: Contemporary Endocrinology ((COE))

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Abstract

Case 1 presented to us in 1982, at age 67, after taking levothyroxine (T4) for 10 yr. Her thyroid was nontender, quite firm, and diffusely enlarged, with an estimated size of 50 g. Her antithyroid microsomal antibody titer was 1:1 600,000 and her antithyroglobulin antibody level was 50 radioimmunoassay (RIA) units*. On a T4 dose of 150 pg daily, her serum thyrotropin [thyroid stimulating hormone (TSH)] level was 3.5 mU/L (normal 0.5–5.2). The presumed diagnosis was chronic lymphocytic (Hashimoto’s) thyroiditis. T4 was continued. In 1987, because her thyroid size had not decreased, she had a fine-needle aspiration biopsy (FNAB), that produced only a few groups of oxyphilic follicular cells (Hürthle cells), consistent with Hashimoto’s thyroiditis, but insufficient for a definite diagnosis. Her goiter was stable until May 1995, when she reported 2 wk of severe anterior neck pain that radiated to her ears and jaw. Thyroid size was still about 50 g, the erythrocyte sedimentation rate (ESR) was 76 mm/h (normal up to 18) and the white blood cell count (WBC) was normal.

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Authors
  1. Donald A. Meier MD
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  2. Michael M. Kaplan MD
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Editor information

Editors and Affiliations

  1. Center for Endocrinology, Metabolism, and Molecular Medicine, Northwestern University Medical School, Chicago, IL, USA

    Mark E. Molitch MD

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© 2002 Springer Science+Business Media New York

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Meier, D.A., Kaplan, M.M. (2002). Hypothyroidism and Thyroiditis. In: Molitch, M.E. (eds) Challenging Cases in Endocrinology. Contemporary Endocrinology. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-59259-277-7_5

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  • DOI: https://doi.org/10.1007/978-1-59259-277-7_5

  • Publisher Name: Humana Press, Totowa, NJ

  • Print ISBN: 978-1-61737-249-0

  • Online ISBN: 978-1-59259-277-7

  • eBook Packages: Springer Book Archive

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