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Spontaneous Remission Of Hypothyroidism Due To Hashimoto’s Thyroiditis

How et al., 8191Thyroid cancer

Lancet 2(8191): Aug 23 1980; 427

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Abstract

Hypothyroidism due to Hashimoto’s (chronic lymphocytic) thyroiditis is generally regarded as an irreversible disorder requiring life-long thyroid hormone replacement therapy. Two nonpuerperal cases of spontaneous remission of hypothyroidism due to Hashimoto’s thyroiditis are reported.

Case Details

Personal Characteristics

A 31-year-old woman

Clinical Characteristics

General tiredness, cold intolerance, and enlargement of the thyroid gland. Serum thyroxine (t4) 43 nanomoles/l (normal 70-150), serum thyrotrophin (tsh) 19 mu/l (normal 0-4), and antithyroid microsomal antibodies +++

Remission Characteristics

Serum t4 was now within the normal range (82 nanomoles/l) as was the serum tsh (1.8 mu/l). Over the next 12 months and on no treatment, she remained symptom-free and biochemically euthyroid with the serum tsh levels repeatedly less than 1 mu/l. Tests for antithyroid microsomal antibodies became weakly positive (+), and there was a marked reduction in the size of the goitre

Treatment & Mechanisms

Proposed Remission Mechanisms

Not discussed

Additional Notes

The patient was seen again 2 months later, when the intention was to start thyroxine replacement treatment for the documented primary hypothyroidism. She reported, however, spontaneous improvement of her symptoms