Treatment of subacute thyroiditis with corticotropin.

Abstract

Three distinct entities comprise most cases of subacute or chronic nonsuppurative thyroiditis: subacute nonsuppurative giant cell thyroiditis, struma lymphomatosa (Hashimoto's disease), and Riedel's struma (woody or ligneous thyroiditis). In the past it was believed that these represented stages in the progression of the same disease, but recent clinical and pathological studies have shown them to be separate diseases. Subacute nonsuppurative thyroiditis has also been called pseudotuberculous or giant cell thyroiditis because of the formation of tiny miliary pseudotubercles by polymorphonuclear infiltration of colloid follicles. The cause is unknown. Clinically, the disease is characterized by a painful, tender, firm, usually diffuse enlargement of the thyroid gland, with fever, pain on swallowing, hyperthyroidism at least in the beginning of the disease, elevated sedimentation rate, and polymorphonuclear leukocytosis. The disease is usually self-limited; it runs a variable course for weeks or months and eventually subsides without any permanent impairment of thyroid function, although