Association between lithium use and thyrotoxicosis caused by silent thyroiditis.
OBJECTIVE
To determine the incidence of silent thyroiditis in lithium users and characterize lithium-associated thyrotoxicosis.


METHODS
Retrospective record review.


METHODS
400 consecutive patients (300 with Graves' disease and 100 with silent thyroiditis) who underwent radioiodine scanning of the thyroid.


METHODS
Odds of lithium exposure.


RESULTS
The odds of lithium exposure were increased 4.7-fold in patients with silent thyroiditis compared with those with Graves' disease (95% CI: 1.3, 17). Lithium-associated silent thyroiditis occurred with an incidence rate of approximately 1.3 cases per 1000 person-years, and lithium-associated thyrotoxicosis occurred with an incidence rate of approximately 2.7 cases per 1000 person-years, higher than the reported incidence rates of silent thyroiditis (< 0.03-0.28 cases per 1000 person-years) and of thyrotoxicosis (0.8-1.2 cases per 1000 person-years) in the general population.


CONCLUSIONS
Thyrotoxicosis caused by silent thyroiditis might be associated with lithium use.
Miller
K K
KK
Neuroendocrine Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA.
Daniels
G H
GH
D000328:Adult; D018692:Antimanic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D006111:Graves Disease / Q000188:drug therapy / Q000378:metabolism; D006801:Humans; D007457:Iodine Radioisotopes; D016651:Lithium Carbonate / Q000009:adverse effects* / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013961:Thyroid Gland / Q000378:metabolism; D013966:Thyroiditis / Q000139:chemically induced* / Q000188:drug therapy / Q000378:metabolism; D013971:Thyrotoxicosis / Q000139:chemically induced* / Q000378:metabolism; D013974:Thyroxine / Q000097:blood; D014284:Triiodothyronine / Q000097:blood
D018692:Antimanic Agents; D007457:Iodine Radioisotopes; D014284:Triiodothyronine; D016651:Lithium Carbonate; D013974:Thyroxine