Journal of Clinical and Translational Endocrinology Case Reports · Published 2026-04-18 · DOI 10.1016/j.jecr.2026.100216
Hashimoto's thyroiditis is typically a painless disease. In rare instances, painful Hashimoto's thyroiditis may clinically mimic subacute thyroiditis and lead to improper treatment or delayed therapy. Herein, we present two cases of painful Hashimoto's thyroiditis, each representing different clinical manifestations of this disease. In both cases, elevated antithyroid antibodies and elevated ESR were observed during the onset of the illness. In case 1, a 53-year-old woman had a history of Graves' disease and experienced transient thyroid pain without steroid treatment. Eventually, hypothyroidism ensued. A fine-needle aspiration cytology confirmed the diagnosis of Hashimoto's thyroiditis in the patient. In contrast, in case 2, a 66-year-old woman with no prior thyroid disorders, presented with recurrent episodes of thyroid pain. Although an initial steroid therapy provided temporary relief, tapering the steroid dose led to a resurgence of pain. Ultimately, total thyroidectomy was performed, which ameliorated painful sensation. A histopathological examination of the excised thyroid tissue revealed Hashimoto's thyroiditis. These two cases have expanded the clinical spectrum of uncommon painful Hashimoto's thyroiditis. Taken together with the cases reported in the literature, we further identify two distinct clinical patterns (Rapid vs. Slow progression) based on clinical presentation.
Abstract from DOAJ. Public domain (CC0 1.0).
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