• The Journal of Internal Korean Medicine
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• v.44 no.2
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• pp.277-284
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• 2023

Objective: This study investigated the effects of Guibiondam-tang-gamibang on patients in the thyrotoxic phase of painless thyroiditis. Methods: A patient in the thyrotoxic phase of painless thyroiditis was treated with Guibiondam-tang-gamibang combined with Western medicine (i.e., beta blockers). The effect of treatment was evaluated according to the pulse rate, NRS, the frequency of subjective symptoms, and sleep time. In addition, the thyroid function was evaluated with TSH, Free T4, and T3 using blood tests. Results: After treatment, the pulse rate decreased, and the NRS and frequency of subjective symptoms disappeared after improvement. Sleep time increased. In the thyroid function test, a significant normalization of each value was observed. Conclusion: This study suggests that Guibiondam-tang-gamibang can be effectively treated in patients with painless thyroiditis in the thyrotoxic phase. However, further studies should be conducted.

• Korean Journal of Head & Neck Oncology
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• v.29 no.2
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• pp.83-86
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• 2013

Some clinical diseases, such as granulomatous thyroiditis, tuberculosis, and sarcoidosis can cause granulomatous inflammation in thyroid, and theses have various clinical presentations. Granulomatous thyroiditis is an inflammation of thyroid gland, and may be painful and tender in case of infection, radiation, or trauma. Otherwise, autoimmune conditions, medications, or an idiopathic fibrosis may cause to be a painless thyroididtis. It is self-limited, possibly viral, inflammatory thyroid disorder usually presented with thyroid pain and systemic symptoms. Tuberculosis of the thyroid occurs only rarely and the patient may be asymptomatic. In thyroid sarcoidosis, most common findings are painless, progressive enlargement of the thyroid with normal function. We have experienced a case of chronic granulomatous inflammation of thyroid gland presenting as a painless thyroid nodule and report it with a review of literature.

• The Korean Journal of Cytopathology
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• v.13 no.1
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• pp.33-37
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• 2002

We report two different types of thyroid lymphoma associated with Hashimoto's thyroiditis. Both showed autoantibodies and were compatible with Hashimoto's thyroiditis according to their clinical backgrounds. A 76-year-old female noted a painless, rapidly growing mass in her neck which was diagnosed as diffuse non-Hodgkin's lymphoma, large cell type, after the fine needle aspiration cytology of the thyroid. She underwent chemo-radiotherapy and is free of the disease 10 months after diagnosis. The other patient, a 73-year-old female with a diffuse golfer, was diagnosed on fine needle aspiration cytology as having Hashimoto's thyroiditis. Three years later she developed a hard nodular growth in the both lobes of the thyroid. This was subjected to fine needle aspiration cytology and needle biopsy and was diagnosed as a MALT lymphoma. She refused any treatment and died 12 months after the diagnosis.

• The Korean Journal of Nuclear Medicine
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• v.25 no.1
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• pp.101-109
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• 1991

To diagnosis and understand the pathophysiologic status of thyroid disease, not only hormonal measurments but also thyroid scan is believed to have a unique role. Especially in the cases of the change of the thyroid function by thyroiditis, it is emphasized that thyroid scan can be helpful in differential diagnosis. Discordant results of thyroid hormone levels and thyroid scan are found in transient hyperthyroidism, or in transient hypothyroidism. We analysed and reevaluated thyroid scan to look at the importance of thyroid scan. The results are summerised as folows: 1) 80% of hyperthyroid patients had hyperthyroidism increased RAIU with even density. they are compatible with Graves' disease. 2) 2.1% of hyperthyroid patients had normal or decreased RAIU, which are classfied as high iodine turn over genuine hyperthyroidism. 3) 8.5% of hyperthyroid patients had markedly decreased RAIU at both 2 hour and 24 hour, whose patholgic processes are suggested to be heterogenous namely subacute thyroiditis, postpartum thyroiditis, Hashimoto's thyroiditis, and painless thyroiditis. 4) 45% of hypothyroid patients had increased 24hr RAIU, 30% of hypothyroid patients were normal, 25%, decreased. In conclusion, thyroid scan should be reevaluated its useful role to asses the pathophysiologic status of thyroid disease. Especially in cases of transient thyrotoxicosis, thyroid scan is essential to diagnose and follow up the disease process.

• Journal of the Korean Society of Radiology
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• v.81 no.5
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• pp.1250-1254
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• 2020

The diffuse sclerosing variant of papillary thyroid carcinoma (DSPTC) is uncommon. Herein, we report a rare case of DSPTC in a 9-year-old girl who initially presented with a painless diffuse goiter. Thyroid peroxidase antibody testing yielded positive results, and the initial clinical diagnosis was Hashimoto's thyroiditis. However, thyroid ultrasonography revealed characteristic findings of DSPTC, which was confirmed through the postoperative histopathological diagnosis. Although thyroid cancers are rare in the pediatric population, DSPTC should be included in the differential diagnosis of goiter in these patients. Moreover, ultrasonography may prevent a diagnostic delay and facilitate the detection of a concomitant malignancy.

• The Korean Journal of Nuclear Medicine
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• v.20 no.2
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• pp.85-100
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• 1986

To evaluate the clinical and pathogenetic roles of TSH receptor antibodies in autoimmune thyroid diseases, TBII were measured by TSH-radioreceptor assay methods in 352 patients with Graves' disease, 108 patients with other thyroid diseases and 69 normal persons. The normal range of TBII activity was less than 15%. The frequencies of detectable TBII in 169 patients with untreated Graves' disease, 31 patients with hyperthyroidism under treatment and 70 patients with euthyrodism under treatment were 92.4%, 87.1% and 54.3% respectively. However 12 (21.8%) out of 55 patients who have been in remission more than one year after discontinuation of antithyroid drugs treatment had detectable TBII activities in their sera. In 196 patients with untreated Graves' disease, the frequency of TBII increased by increasing size of goiter and the frequency of proptosis was significantly high in patients whose TBII activities were more than 60%. TBII activities were roughly correlated with total $T_3,\;T_4$ and free $T_4$ index but low $\gamma^2$ value(less than 0.1). In 67 patients with Graves' disease who were positive TBII before antithyroid drugs treatment, TBII activities began to decrease from the third months and it was converted to negative in 35.8% of patients at 12 months after treatment. There were no significant differences of the declining and disappearing rates of TBII activities between high dose and conventional dose groups. TBII activities were significantly increased initially (2-4 months) and then began to decrease from 5-9 months after $^{131}I$ treatment. There were two groups, one whose TBII activities decreased gradually and the other did not change untill 12 months after subtotal thyroidectomy. Although preoperative clinical and laboratory findings of both groups were not different, TBII activities of non-decreasing group were significantly higher than those of decreasing group$(74.6{\pm}18.6%\;vs\;39.2{\pm}15.2%;\;P<0.01)$. Thirty three(55.9%) out of 59 patients with Graves' disease relapsed within 1 year after discontinuation of antithyroid drugs. The positive rate of TBII at the end of antithyroid drug treatment in relapse group(n=33) was significantly higher than those in remission group (n=26) (63.6% vs 23.1%; P < 0.05). The mean value of TBII activities at the end of antithyroid drug treatment in relapse group was significantly elevated $(29.7{\pm}21.4%\;vs\;14.7{\pm}11.1%,\;P<0.05)$. Positive predictive value of TBII for relapse was 77.8%, which was not different from those of TRH nonresponsiveness(78.6%). The frequencies of detectable TBII in 68 patients with Hashimoto's thyroiditis, 10 patients with painless thyroiditis and 5 patients subacute thyroiditis were 14.7%, 20% and 0%, respectively. However in 25 patients with primary nongoitrous myxedema, 11 patients(44%) showed TBII activities in their sera. 9 out of 11 patients who had TBII activities in their sera showed high TBII activities(more than 70% binding inhibition) and their IgG concentrations showing 50% binding inhibition of $^{125}I-bTSH$ to the TSH receptor were ranges of 0.1-2.6 mg/dl. One patient who had high titer of TBII in her serum delivered a hypothyroid baby due to transplacental transfer of maternal TBII. These findings suggested that 1) TSH receptor antibodies are closely related to a pathogenetic factor of Graves' hyperthyroidism and of some patients with primary non-goitrous myxedema, 2) measurement of TSH receptor antibodies is helpful in evaluating the clinical outcome of patients with Graves' disease during antithyroid drug treatment and in predicting the neonatal transient hypothyroidism of baby delivered from primary myxedema patients. 3) there are 2 or more different types of TSH receptor antibodies in autoimmune thyroid diseases including one which stimulates thyroid by binding to the TSH receptor and another which blocks adenylate cyclase stimulation by TSH.