Painless thyroiditis occurring during post-menopausal period, following remission of Graves’ disease

Abstract

Painless thyroiditis (also called “silent thyroiditis”) is a clinical entity that belongs to the spectrum of autoimmune thyroiditis (1). Patients usually experience an initial thyrotoxic phase, followed by a hypothyroid state and returning to a euthyroid state. This disorder often develops in patients with positive tests for anti-thyroid antibodies during the post-partum period (2). Thyrotoxicosis observed in painless thyroiditis differs from that in Graves’ disease. In the former, thyroid hormones leak into the circulation as a result of thyroid destruction, whereas in the latter anti-TSH receptor antibodies stimulate production and secretion of thyroid hormones. The therapeutic approaches for both disorders are completely different and thus differential diagnosis is important in clinical practice. Here, we describe a patient developing painless thyroiditis during menopausal pe