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Five patients with painless thyroiditis simultaneously developed in a nursery school.

T Ogura1, S Hirakawa, S Suzuki

  • 1Third Department of Internal Medicine Okayama University Medical School, Japan.

Endocrinologia Japonica
|April 1, 1988
PubMed
Summary

Painless thyroiditis (PT) cases occurred in nursery school workers, presenting with leg edema and weight loss, not typical neck pain. This suggests an environmental trigger, possibly an unidentified virus, caused the transient thyrotoxicosis.

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Area of Science:

  • Endocrinology
  • Environmental Medicine
  • Epidemiology

Background:

  • Painless thyroiditis (PT) is a form of thyroid dysfunction.
  • Simultaneous PT cases in a nursery school population are unusual.
  • Clinical presentation can mimic subacute thyroiditis.

Purpose of the Study:

  • To investigate an outbreak of painless thyroiditis in a nursery school.
  • To identify potential causes and clinical characteristics of the observed PT cases.
  • To understand the role of environmental factors in PT etiology.

Main Methods:

  • Case study of five individuals (1 male, 4 females) aged 21-52.
  • Clinical examination, blood tests (CRP, liver function), thyroid function tests (RAIU, TGHA, MCHA), and viral antibody titers.

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  • Analysis of environmental exposure within the nursery school setting.

    • Main Results:

    • Patients presented with leg edema, palpitations, and weight loss, but no goiter or neck pain.
    • Thyroid function showed transient thyrotoxicosis with reduced radioactive iodine uptake (RAIU).
    • Autoimmune markers (TGHA, MCHA) and CRP were negative; mild liver function impairment in some patients.

    Conclusions:

    • The outbreak suggests an environmental factor, potentially an unidentified virus, triggered PT.
    • The thyrotoxicosis was transient and resolved with or without glucocorticoid treatment.
    • Further research is needed to confirm environmental triggers for painless thyroiditis.