Incidence rate of symptomatic painless thyroiditis presenting with thyrotoxicosis in Denmark as evaluated by consecutive thyroid scintigraphies
Abstract
Frederik Schwartza, Natasha Bergmanna, Bo Zerahnb & Jens Faber*aca Department of Medicine O, Centre of Endocrinology and Metabolismb Department of Clinical Physiology and Nuclear Medicine, Herlev Hospitalc Faculty of Health Sciences, University of Copenhagen, DenmarkCorrespondence: Jens Faber, professor, Department of Medicine O, Centre of Endocrinology and Metabolism, Herlev University Hospital, DK-2730, Denmark. Tel: + 45 3868 9016. E-mail: jens.faber@regionh.dk.AbstractBackground. Painless thyroiditis (PT) is a transient kind of thyrotoxicosis, with lack of uptake on a thyroid scintigraphy in a non-tender thyroid gland, elevated anti-TPO antibodies, no fever, no history of increased iodine intake, and a normal sedimentation rate. The prevalence of PT varies hugely in the literature. Objective. To establish the incidence rate of PT in Denmark as well as to describe the phenotype of PT in more detail. Methods. Tc-99m pertechnetate scintigraphies were performed over a period of 9.75 years on 6022 consecutive patients (2349 had a thyrotoxic episode), and were divided into high or normal (5528), reduced (300) or lack of uptake (194). Patient records were evaluated: 292 with reduced, and 186 with lack of uptake. As a control measure, 230 consecutive thyrotoxic patients were also analyzed. Results. Based on scintigraphies, 12 patients had PT, 10 with lack of uptake and two with reduced, corresponding to an incidence rate of 0.49/100,000 person years. It was predicted, that only one patient among the newly diagnosed consecutive thyrotoxic cohort had PT. This patient was identified. The prevalence of PT among thyrotoxic patients was 0.51% as evaluated by scintigraphy, and 0.43% among the biochemically thyrotoxic patient cohort. Twenty-five percent had more than one thyrotoxic episode, 75% had at least one subsequent hypothyroid episode, and 33% developed permanent hypothyroidism. Conclusions. PT presenting with symptomatic thyrotoxicosis is an extremely rare disease in Denmark. Symptomatic PT presents most often with no uptake on a Tc-99m pertechnetate scintigraphy. Clinical follow-up is essential.
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Painless thyroiditis caused by lymphocytic inflammation occurs with different frequency depending on the population studied: 0.5% in Denmark, 6% in Toronto, and 22% in Wisconsin.
“in Denmark it accounted for only 0.5% of thyrotoxic patients, but it was 6% of patients in Toronto and 22% of patients in Wisconsin (16)(17)(18).”
From 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis (2016) · cites this paper as [16]
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- Authors
- Schwartz, F., Bergmann, N., Zerahn, B., & Faber, J.
- Affiliations
- Herlev Hospital (DK)
- University of Copenhagen (DK)
- Corresponding author
- Faber, Jens
- Venue
- Scandinavian Journal of Clinical and Laboratory Investigation
- Publisher
- Informa UK Limited
- Published
- 2013-02-26
- Volume
- 73
- Issue
- 3
- Pages
- 240-244
- ISSN
- 0036-5513 (ISSN-L)
- 1502-7686
- OpenAlex
- W2076765296
- Cited by
- 32
- References
- 16
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 3 · 2023: 1 · 2022: 4 · 2021: 3 · 2020: 2 · 2019: 1 · 2018: 3 · 2017: 2 · 2016: 6 · 2015: 2 · 2014: 1 · 2013: 1
- FWCI
- 2.62
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Scandinavian Journal of Clinical and Laboratory Investigation (publishedVersion)
- PubMed (publishedVersion)
- Research at the University of Copenhagen (University of Copenhagen) (submittedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Cancer Diagnosis and Treatment
- Health Sciences › Medicine › Pathology and Forensic Medicine › Ophthalmology and Eye Disorders
- Keywords
- painless thyroiditis, thyrotoxicosis, incidence, thyroid scintigraphy, hypothyroidism, thyroid peroxidase antibodies, Denmark, rare diseases, thyroid autoimmunity
- MeSH terms
- Adolescent, Adult, Aged, Denmark, Female, Humans, Male, Middle Aged, Radionuclide Imaging, Sodium Pertechnetate Tc 99m, Thyroid Gland, Thyroiditis, Thyrotoxicosis, Incidence
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