Abstract
A 41-year-old female with rheumatoid arthritis had nontender enlarged thyroid gland. Thyroid function tests revealed increased concentrations of serum free T3 (FT3, 10.8 pmol/L) and free T4 (FT4, 31.1 pmol/L) with suppressed concentration of thyrotropin (TSH, lower than 0.1 mU/L) and low 24-hour thyroidal radioactive iodine uptake (1.6%). Serum thyrotropin receptor antibody (TRAb) was negative (0%) and she had positive anti-thyroglobulin and anti-microsomal antibodies. A diagnosis of silent thyroiditis was made based on laboratory findings. Serum concentrations of FT3 and FT4 normalized one month later without treatment. The causal relationship between the two diseases is discussed.
Similar content being viewed by others
References
Amino N. Painless thyroiditis. Shindan to Chiryou 73:2167, 1985. (in Japanese).
Dorfman S.G., Cooperman M.T., Nelson R:G., Deputy H., Peake R.L., Young R.L. Painless thyroiditis and transient hyperthyroidism without goiter. Ann. Intern. Med. 86: 24. 1977.
Hamburger J.I., Meier D.A. A silent thyroiditis and postpartum silent thyroiditis forms chronic thyroiditis or different (new) forms of viral thyroiditis?. In: Hamburger J.I., Miller J.M. (Eds). Controversies in Clinical Thyroidology. Springer-Verlag Inc, New York, 1981. p. 21.
Nikolai T.F., Brosseau J., Kettrick M.A., Roberts R., Betaos E. Lymphocytic thyroiditis with spontaneously resolving hyperthyroidism (silent thyroiditis). Arch. Intern. Med. 140: 478, 1980.
Nikolai T.F. Silent thyroiditis. In: Ingbar S.H., Braverman L.E. (Eds). The Thyroid, ed. 5th. Lippincott, Philadelphia, 1986. p. 1098.
Vargas M.T., Briones-Urbina R., Gladman D., Papsin F.R., Walfish P.G. Antithyroid microsomal autoantibodies and HLA-DR5 are associated with postpartum thyroid dysfunction: Evidence supporting an autoimmune pathogenesis. J. Clin. Endocrinol. Metab. 67:327, 1988.
Walfish P., Chan J.Y. Post-partum hyperthyroidism. Clin. Endocrinol. Metabol. 74:417, 1985.
Buchanan W.W. The relationship of Hashimoto’s thyroiditis to rheumatoid arthritis. Geriatrics 20:941, 1965.
Takehisa Y., Miyoshi M.., Suzuki S., Terami T., Oohara A., Ezawa H. Anti-thyroid antibodies and thyroid function in rheumatoid arthritis. Ryumachi 12:342, 1972. (in Japanese).
Montero E., Ceboleio C., Galvac-Teles. Autoantibodies in rheumatic disease. Lancet 2: 797, 1975.
Beare R.L.B. Lymphadenoid goiter (Hashimoto’s disease). Br. Med. J. 7:480, 1958.
Torizuka K., Konishi J., Mori T. Hashimoto’s disease. Naika 38:379, 1976. (in Japanese).
Murayama H., Kato M., Mizuno O., Kataoka K., Matsuki S. Transient thyrotoxicosis occurred after cessation of steroid therapy in a patient with autoimmune thyroiditis and rheumatoid arthritis. Endocrinol. Jpn. 29: 583, 1982.
Arnett F.C., Edworthy S.M., Bloch D.A., McShane D.J., Fries J.F., Cooper N.S., Healey L.A., Kaplan S.R., Liang M.H., Luthra H.S., Medsger T.A. Jr., Mitchell D.M., Neustadt D.H., Pinals R.S., Schaller J.G., Sharp J.T., Wilder R.L., Hunder G.G. The american rheumatism association 1987 revised criteria for the classification of rheumatoid arthritis. Arth. Rheumat. 37:315, 1988.
Hijimans W., Doniach D., Roit I.M., Holbow E.J. Serological overlap between lupus erythematosus, rheumatoid arthritis, and thyroid auto-immune disease. Br. Med. J. 2: 909, 1961.
Becker K.L., Titus J.L., Woolner L.B., Ferguson R.H. Thyroiditis and rheumatoid arthritis. Mayo Clin. Proc. 38:125, 1963.
Becker K.L., Ferguson R.H., McConahey W.M. The connective-tissue diseases and symptoms associated with Hashimoto’s thyroiditis. N. Engl. J. Med. 268:277, 1963.
Haraguchi K., Hiramatsu K., Onaya T. Transient thyrotoxicosis after unilateral adrenolecto-my in two patients with Cushing’s syndrome. Endocrinol. Jpn. 31:577, 1984.
Takasu N., Komiya I., Nagasawa Y., Asawa T., Yamada T. Exacerbation of autoimmune thyroid dysfunction after unilateral adrenalectomy in patients with Cushing’s syndrome due to an adrenocortical adenoma. N. Engl. J. Med. 322: 1708, 1990.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Sakata, S., Nagai, K., Shibata, T. et al. A case of rheumatoid arthritis associated with silent thyroiditis. J Endocrinol Invest 15, 377–380 (1992). https://doi.org/10.1007/BF03348757
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/BF03348757