Gorman C A, Duick D S, Woolner L B, Wahner H W
Mayo Clin Proc. 1978 Jun;53(6):359-65.
We have studied seven episodes of transient hyperthyroidism in three men and one woman, aged 19 to 38 years. No patient had fever or neck tenderness. All had palpable thyroid glands. Elevated serum thyroxine values persisted for 1 to 3 months. Thyroid131I uptake at 6 and 24 hours was low (1 to 3%). Erythrocyte sedimentation rates were normal or only slightly increased. Needle biopsy in four patients and a thyroidectomy specimen in one patient, all taken during the hyperthyroid phase, showed lymphocyte infiltration and extensive follicular disruption without oxyphilia. There was no evidence of granulomatous thyroiditis. Thyroglobulin antibodies were normal in all. In three patients, transient hypothyroidism followed the hyperthyroid episode. In two patients, the condition was recurrent. The findings are compatible with transient unregulated discharge of thyroid follicle content in some patients with lymphocytic thyroiditis. Recognition permits avoidance of unnecessary treatment with surgery, radioiodine, or antithyroid drugs.
我们研究了3名男性和1名女性（年龄在19至38岁之间）出现的7次短暂性甲状腺功能亢进发作。所有患者均无发热或颈部压痛。甲状腺均能触及。血清甲状腺素值升高持续1至3个月。甲状腺131I摄取在6小时和24小时时较低（1%至3%）。红细胞沉降率正常或仅略有升高。4例患者的针吸活检及1例患者的甲状腺切除标本（均在甲状腺功能亢进期获取）显示淋巴细胞浸润和广泛的滤泡破坏，无嗜酸性变。没有肉芽肿性甲状腺炎的证据。所有患者的甲状腺球蛋白抗体均正常。3例患者在甲状腺功能亢进发作后出现短暂性甲状腺功能减退。2例患者病情复发。这些发现与一些淋巴细胞性甲状腺炎患者甲状腺滤泡内容物的短暂性无调节释放相符。认识到这一点可避免不必要的手术、放射性碘或抗甲状腺药物治疗。
