ACUTE SPONTANEOUS HEMORRHAGIC DEGENERATION OF THE THYROID-NODULE WITHSUBACUTE THYROIDITIS-LIKE SYMPTOMS AND LABORATORY FINDINGS

Seventeen consecutive patients (3 men and 14 women, aged 14-75 years) with a hemorrhagic degeneration of the thyroid nodule, which was confi rmed by both ultrasonography and either reddish or brown fluid evacuat ed by fine-needle aspiration, were classified as either acute type wit h an episode of abrupt painful swelling of the thyroid (n=4), or chron ic type in which a painless thyroid nodule was incidentally found (n=1 3). One of the four acute type patients demonstrated subacute thyroidi tis-like symptoms and laboratory findings including transient painful thyrotoxicosis associated with high serum levels of thyroid hormones a nd thyroglobulin (Tg), a suppressed serum TSH level, a low thyroidal r adioactive iodine uptake (RAIU), and an accelerated erythrocyte sedime ntation rate (ESR). In the other three acute type patients the serum l evel of Tg increased markedly, the serum thyroid hormones level increa sed in one, the thyroidal RAIU was low in two, and the ESR was acceler ated in one. In the thirteen chronic type patients, the serum levels o f the thyroid hormones and the thyroidal RAIU were within the normal r ange, and few inflammatory signs were observed. These findings suggest that acute hemorrhagic degeneration of the thyroid nodule may thus ca use transient subacute thyroiditis-like symptoms and laboratory findin gs.