Sequential Study of the Impairment of Thyroid Function in the Early Stage of Subacute Thyroiditis

Abstract

A sequential study of various parameters of thyroid metabolism has been carried out in 2 patients during the weeks following the clinical onset of subacute thyroiditis, the aim being to define the nature and extent of the anomalies of thyroid function. In the early stage, serum thyroxine, protein bound iodine and T3 resin uptake levels were in the thyrotoxic range. In both cases, the serum thyroxine values further decreased with a half-life of 7 days and reached the hypothyroid range at the 6–7th week. Both 131I uptake and TSH plasma levels were found to be low and concomitantly rose at the 6–7th week. In one patient the serum thyroglobulin level was strikingly elevated at the beginning and then fell fairly rapidly; however in both patients, the serum thyroglobulin values remained abnormal. The present study confirmed the concept of a sudden release of preformed hormone stores. Furthermore, the following points were evident: a) marked and transient release of thyroglobulin; b) interruption of the secretory activity during at least 7 weeks; c) adequate functioning of the pituitary-thyroid control mechanism and d) partial recovery of the thyroidal iodine uptake at a time when the hormone secretion was still undetectable.

Elevated serum thyroglobulin. A marker of metastases in differentiated thyroid carcinomas.

“…Inasmuch as previous studies indicated that serum thyroglobulin levels are equally elevated in patients with Graves' disease and subacute thyroiditis (4,11), the test in its present form cannot be regarded as a specific one for the detection of thyroid cancer. This measurement, however, can be usefully applied in patients with histologically established thyroid carcinoma to assess the effective therapeutic manipulation of tumor mass if return of serum thyroglobulin levels into the normal range reflects total removal of the tumor mass.…”

Serum Thyroglobulin and Thyroglobulin Autoantibodies in Thyroid Diseases

“…Most pronounced elevations are seen after damage to the thyroid gland, e.g. in active subacute thyroiditis (49,120) or following surgery or radioiodine treatment (41,120), and also in metastatic thyroid carcinoma ( 120). Elevated serum Tg is seen in some patients with nontoxic goitre, depending on iodine supply (84) and the size of the goitre (98,110).…”

Serum thyroglobulin levels in the diagnosis and follow-up of subacute 'painful' thyroiditis. A sequential study

“…Thirty-eight patients (30 female and eight male), aged 17 to 68 years, with subacute thyroiditis were studied by approximately the tenth day after the onset of symptoms.…”