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Association between lithium use and thyrotoxicosis caused by silent thyroiditis
1Neuroendocrine Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA.
Objective:
To determine the incidence of silent thyroiditis in lithium users and characterize lithium-associated thyrotoxicosis.
Design:
Retrospective record review.
Patients:
400 consecutive patients (300 with Graves' disease and 100 with silent thyroiditis) who underwent radioiodine scanning of the thyroid.
Measurements:
Odds of lithium exposure.
Results:
The odds of lithium exposure were increased 4.7-fold in patients with silent thyroiditis compared with those with Graves' disease (95% CI: 1.3, 17). Lithium-associated silent thyroiditis occurred with an incidence rate of approximately 1.3 cases per 1000 person-years, and lithium-associated thyrotoxicosis occurred with an incidence rate of approximately 2.7 cases per 1000 person-years, higher than the reported incidence rates of silent thyroiditis (< 0.03-0.28 cases per 1000 person-years) and of thyrotoxicosis (0.8-1.2 cases per 1000 person-years) in the general population.
Conclusion:
Thyrotoxicosis caused by silent thyroiditis might be associated with lithium use.
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