I couldn't have put a name to it
-----Original Message-----
From: GP-UK [mailto:[log in to unmask]] On Behalf Of Julian Bradley
Sent: 05 March 2010 22:15
To: [log in to unmask]
Subject: Re: A story - part 4
>Anti thyroid Abs, Hashimoto's negative.
>
>The presumed diagnosis is Subacute granulomatous thyroidits.
>
>http://emedicine.medscape.com/article/125648-overview
>
>Why does it matter?
>
>Patient feels rotten (ESR may be 100+ but not always), TFTs abnormal
>(initially toxic, then hypo) but it resolves spontaneously.
>
>It's a low iodine uptake situation, carbimazole doesn't work and
>isn't helpful.
>When become hypo it's transient - they _don't_ need to go onto
>thyroxine for life.
>
>"The hypothyroid phase may last up to 2 months. Ninety to 95% of
>patients return to normal thyroid function."
>
>This is a diagnosis I really wasn't very conscious of, and if rpt
>TFTs came back abnormal (ie no laboratory error) I'd always treated
>on that basis - especially hypothyroidism.
>
>Julian
Another brief update on this "story".
I now understand that the patient, without carbimazole or any
anti-thyroid treatment, has a normal T4, but the ESR is 86,
consistent with the presumed diagnosis. She apparently feels better
++ since beta-blocker treatment (despite high ESR).
Is this story of any use - or did everyone else know about this and
the possibility of transient hypothyroidism already?
J
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