| Diagnostic Approach and Therapeutic Strategies for Ambiguous Thyrotoxicosis |
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Mijin Kim1 |
1Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
2Division of Endocrinology and Metabolism, Department of Internal Medicine, Pusan National University Hospital, Busan, Korea |
| 애매한 갑상선중독증의 진단적 접근과 치료 전략 |
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김미진1 |
1부산대학교 의과대학 내과학교실
2부산대학교병원 내분비대사내과 |
Correspondence:
Mijin Kim, Tel: +82-51-240-7738, Fax: +82-51-254-3237, Email: mijinkim08@gmail.com
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Received: 8 September 2025 • Revised: 24 September 2025 • Accepted: 30 September 2025 |
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| Abstract |
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Thyrotoxicosis is a clinical syndrome caused by elevated circulating thyroid hormones, most commonly due to Graves’ disease but also seen in thyroiditis or nodular disease. Differentiating the etiology is crucial because treatment strategies vary, yet in practice, clinical features may overlap, making diagnosis challenging. We describe two illustrative cases: a young woman with recurrent Graves’ disease presenting with palpitations, weight loss, and positive thyroid stimulating hormone receptor antibody, and a man with rapid weight loss but no typical symptoms or eye signs who was initially misdiagnosed and treated with antithyroid drugs, later confirmed as painless thyroiditis with spontaneous recovery. These cases underscore the importance of integrating clinical history, physical findings, thyroid function tests, autoantibody assays, ultrasonography, and thyroid scan in the diagnostic process, while emphasizing that short-term follow-up can be decisive in ambiguous cases. Indiscriminate use of antithyroid drugs should be avoided, as careful stepwise evaluation and observation are essential for accurate diagnosis and safe management of patients with thyrotoxicosis. |
| Key Words:
Thyrotoxicosis; Graves disease; Painless thyroiditis; Diagnosis, differential |
| 주제어:
갑상선중독증; 그레이브스병; 무통갑상선염; 감별 진단 |
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