Abstract
Over an 8-year period, a male patient presented three times to an endocrinologist with strikingly similar presentations, including palpitations, anxiety, and tremors. Each of his presentations occurred following either the birth of one of his two children or his wife's late termination of pregnancy. This patient's illness followed the typical time course of silent thyroiditis: hyperthyroidism, followed by euthyroidism, a late hypothyroid phase, and then a complete resolution of symptoms and normalization of thyroid function tests over a period of several months. We discuss the curious clinical presentation, diagnostic evaluation, and a literature review of alternate explanations for this patient's condition, including a discussion of the impact of seasonal shift, spousal's autoimmune disease, stress, and evolutionary changes in males postpartum. Although the differential diagnosis is broad in this case and the thyrotoxicosis could have coincidentally followed pregnancies of the patient's wife, documented hormonal changes in men during postpartum period in conjunction with the timeline of the patient's condition are suggestive of recurrent “sympathetic” postpartum thyroiditis. To our knowledge, this is the first case report of recurrent painless thyroiditis in a man following pregnancies of his wife with Hashimoto's thyroiditis.
Highlights
Silent thyroiditis, known as painless or subacute lymphocytic thyroiditis, is one of several autoimmune thyroid disorders [1]
The clinical presentation of postpartum thyroiditis is virtually identical to that of silent thyroiditis, except that postpartum thyroiditis occurs in women within 1 year after delivery and rarely develops one month postpartum
We present a curious case of a man who developed painless thyroiditis three times coinciding with the postpartum period of his wife with Hashimoto’s thyroiditis
Summary
Known as painless or subacute lymphocytic thyroiditis, is one of several autoimmune thyroid disorders [1]. The clinical presentation of postpartum thyroiditis is virtually identical to that of silent thyroiditis, except that postpartum thyroiditis occurs in women within 1 year after delivery and rarely develops one month postpartum. It is typically associated with the development of either transient hyperthyroidism or hypothyroidism or both up to 1 year postpartum with eventual return to a euthyroid state [2, 3]. We present a curious case of a man who developed painless thyroiditis three times coinciding with the postpartum period of his wife with Hashimoto’s thyroiditis
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