A Case of Recurrent Painless Thyroiditis and Discussion of Management

This article discusses a case of recurrent painless thyroiditis in a Korean woman monitored from age 38 to 60, experiencing at least seven episodes of the condition. These episodes were characterized by transient thyrotoxicosis, palpitations, hair loss, and dyspnea, with suppressed TSH and elevated free T4 levels. Despite negative TSI, TPO, and TSH receptor antibodies, thyroglobulin antibody was elevated. A radioactive iodine uptake scan showed low uptake during episodes. The patient declined radioactive iodine treatment, which could prevent recurrence but may cause permanent hypothyroidism. The case highlights the challenges in managing recurrent painless thyroiditis due to the lack of established guidelines, suggesting that treatment decisions should consider episode frequency, severity, patient symptoms, and preferences.