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The article describes the case of a 37-year-old woman who was admitted in an emergency department for tremulousness, breath shortness and palpitations. The patient was diagnosed by her physician with Graves' hyperthyroidism, which is considered as a common disorder in women. According to the author, untreated hyperthyroidism can lead to cardiovascular illnesses such as atrial fibrillation.

The article presents a case study of a 36-year-old man with fevers, focusing on the diagnostic process leading to the diagnosis of subacute thyroiditis possibly triggered by a previous asymptomatic Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection. Topics discussed include the clinical presentation, differential diagnosis involving infectious and noninfectious causes of fever, and the diagnostic workup involving laboratory tests and imaging studies.

A response by D.S. Ross to the letters to the editor about his article "Radioiodine therapy for hyperthyroidism," in the February 10, 2011 issue is presented.

The article describes the case of a teenage girl who presented an enlarging neck mass in a pediatric endocrinology clinic. Aside from the physical symptom of neck swelling, the patient also complained of occasional nausea and neck tightness. Details about her clinical background are discussed, noting that her family has a history of hypothyroidism. Surgical treatment has been recommended following the detection of a papillary thyroid carcinoma within the right isthmus of the thyroid of the patient.

Background: To detect recurrent disease in patients who have had differentiated thyroid cancer, periodic withdrawal of thyroid hormone therapy may be required to raise serum thyrotropin concentrations to stimulate thyroid tissue so that radioiodine (iodine-131) scanning can be performed. However, withdrawal of thyroid hormone therapy causes hypothyroidism. Administration of recombinant human thyrotropin stimulates thyroid tissue without requiring the discontinuation of thyroid hormone therapy. Methods: One hundred twenty-seven patients with thyroid cancer underwent whole-body radioiodine scanning by two techniques: first after receiving two doses of thyrotropin while thyroid hormone therapy was continued, and second after the withdrawal of thyroid hormone therapy. The scans were evaluated by reviewers unaware of the conditions of scanning. The serum thyroglobulin concentrations and the prevalence of symptoms of hypothyroidism and mood disorders were also determined. Results: Sixty-two of the 127 patients had positive whole-body radioiodine scans by one or both techniques. The scans obtained after stimulation with thyrotropin were equivalent to the scans obtained after withdrawal of thyroid hormone in 41 of these patients (66 percent), superior in 3 (5 percent), and inferior in 18 (29 percent). When the 65 patients with concordant negative scans were included, the two scans were equivalent in 106 patients (83 percent). Eight patients (13 percent of those with at least one positive scan) were treated with radioiodine on the basis of superior scans done after withdrawal of thyroid hormone. Serum thyroglobulin concentrations increased in 15 of 35 tested patients: 14 after withdrawal of thyroid hormone and 13 after administration of thyrotropin. Patients had more symptoms of hypothyroidism (P<0.001) and dysphoric mood states (P<0.001) after withdrawal of thyroid hormone than after administration of thyrotropin. Conclusions: Thyrotropin stimulates radioiodine uptake for scanning in patients with thyroid cancer, but the sensitivity of scanning after the administration of thyrotropin is less than that after the withdrawal of thyroid hormone. Thyrotropin scanning is associated with fewer symptoms and dysphoric mood states. (N Engl J Med 1997;337:888-96.) [ABSTRACT FROM AUTHOR]