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Recurrent transient thyrotoxicosis in multinodular goitre.

R Arem1

  • 1Department of Medicine, Baylor College of Medicine, Houston, Texas 77030.

Postgraduate Medical Journal
|January 1, 1990
PubMed
Summary

Thyroid nodules can cause transient hyperthyroidism, resolving spontaneously due to infarction. This phenomenon, seen in nodular goiter, mimics other causes of thyrotoxicosis.

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Area of Science:

  • Endocrinology
  • Thyroidology

Background:

  • Autonomously functioning thyroid nodules can present with hyperthyroidism.
  • Thyroidal infarction is a recognized, though uncommon, cause of spontaneous resolution of hyperthyroidism.

Observation:

  • A patient experienced recurrent hyperthyroidism episodes linked to distinct thyroid nodules.
  • Both the right and left hyperfunctioning nodules became non-functional (cold/hypofunctioning) on scintigraphy after hyperthyroid episodes resolved.
  • Aspiration of the right nodule revealed hemorrhagic fluid, suggesting hemorrhagic infarction.

Findings:

  • Spontaneous resolution of thyrotoxicosis in this patient was attributed to nodular infarction.
  • Recurrent hyperthyroidism occurred due to sequential infarction of different nodules.

Implications:

  • Nodular infarction should be considered in the differential diagnosis of recurrent or transient hyperthyroidism, particularly in patients with nodular goiter.
  • This case highlights an unusual mechanism for spontaneous euthyroidism restoration in thyroid nodular disease.

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