A Case of Repeated Painless Thyroiditis Followed by Graves' Disease.

Occurrence and Spontaneous Remission of Graves' Hyperthyroidism Preceded by Painless Thyroiditis.

“…SEVERAL reports have described the development of hyperthyroidism due to Graves' disease preceded by painless thyroiditis [1][2][3]. Although the mechanism of this phenomenon is still unclear, the most feasible explanation is as follows: Damage to thyroid epithelial cells leads to the release of TSH receptor, thyroglobulin (Tg) and microsomal antigens, which in turn leads to the stimulation of helper T cells, inducing the production of autoantibodies to TSH receptor, antithyroglobulin (TGHA) and antimicrosomal (MCHA) antibodies [3].…”

“…Although the mechanism of this phenomenon is still unclear, the most feasible explanation is as follows: Damage to thyroid epithelial cells leads to the release of TSH receptor, thyroglobulin (Tg) and microsomal antigens, which in turn leads to the stimulation of helper T cells, inducing the production of autoantibodies to TSH receptor, antithyroglobulin (TGHA) and antimicrosomal (MCHA) antibodies [3]. In contrast, it has been reported that painless thyroiditis recurred in the same patient [3][4][5]. Since the therapeutic procedures for Graves' disease and painless thyroiditis are completely different, the differential diagnosis of the two disorders is very important [4].…”

Uncommon Causes of Thyrotoxicosis

“…On the basis of these findings, silent thyroiditis resembles a mild form of Graves' disease or subacute thyroiditis. In fact, Graves' disease and silent thyroiditis are not mutually exclusive, as patients can develop one after having had the other (102)(103)(104), and in one report, the patient had both simultaneously (105). Silent thyroiditis is principally differentiated from Graves' disease on the basis of a low radioiodine uptake (similar to subacute thyroiditis) and from subacute thyroiditis in that patients experience no pain and there is no viral prodrome.…”

Four Cases of Graves' Disease which Developed after Painful Hashimoto's Thyroiditis

“…This is a form of the destructive thyroiditis. Therefore destruction of the thyroid follicular structure due to painful Hashimoto (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12) and the destructive condition of the thyroid follicular structure, for example, surgical treatment for thyroid nodules (14), radioiodine therapy for a toxic nodular goiter (30)(31)(32), and external irradiation (13) (5-9, 10, 11 …”