J.Jpn. Surg. Soc.. 61(3): 315-339, 1960

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THE CLINICO-PATHOLOGICAL STUDIES ON THYROIDITIS WITH SPECIAL REFERENCE TO DE QUERVAIN'S THYROIDITIS

The author performed clinico-pathological studies on 17 cases of de Quervain's thyroiditis and 6 cases of Hashimoto's disease. The results are summerized as follows :
1) It is already known that de Quervain's thyroiditis is of rather acute onset often heralded by pain in the throat and frequently associated with fever and malais, but some patients of the disease are free from pain and fever, and the course of the illness ranging from several weeks to 1 year or more.
So the author prefer to use "de Quervain's thyroiditis" rather than "subacute thyroiditis".
2) The laboratory data of de Quervain's thyroiditis are as follows:
The uptake of ¹³¹I is severely depressed, and the Ievel of serum protein-bound iodine is almost normal.
The erythrocyte-sedimentation-rate is high, frequently above 100 mm, but it returns to normal in proportion to the disappearance of clinical signs.
The proportion of the various fractions of serum protein by electrophoresis shows the albumin to be decreased and the alpha and beta globulin to be increased.
3) Histologically, de Quervain's thyroiditis is considered as a foreign body reaction to the colloid denuded to the stroma, following partial destruction of the follicular epithelia.
4) The histlogic findings of the thyroid gland of one patient dead from rheumatism is resemble closely to that of de Quervain's thyroiditis.
Sometimes de Quervain's thyroiditis is accompanied with rheumatism clinically, and the vascular lesion of the illness is notable.
These are suggested that rheumatism is one of the causative factors of de Quervain's thyroiditis.
5) The fairly prolonged administration of a small dose of T.S.H. (thyrostimulating hormone) obtains the desirable result clinically, It is proved histologically by repeated biopsies that T.S. H. spurs the regeneration of follicles.
6) By repeated biopsies, the remarkablly regenerated follicles are illustrated in de Quervain's thyroiditis. Two years after the onset of the illness, almost normal thyroidal stucture is found.
On the contrary, the pathologic findings of Hashimoto's disease are almost the same as those which were noted 3 years before.
From both findings mentioned above and clinical standpoints, de Quervain's and Hashimoto's disease are regarded as distinct illness respectively.
(Author's abstract)

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