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Case Reports
. 2003 Sep 2;169(5):415-7.

Recurrent hamburger thyrotoxicosis

Malvinder S Parmar  1 , Cecil Sturge
Affiliations
Case Reports

Recurrent hamburger thyrotoxicosis

Malvinder S Parmar et al. CMAJ. .

Abstract

Recurrent episodes of spontaneously resolving hyperthyroidism may be caused by release of preformed hormone from the thyroid gland after it has been damaged by inflammation (recurrent silent thyroiditis) or by exogenous administration of thyroid hormone, which might be intentional or surreptitious (thyrotoxicosis factitia). Community-wide outbreaks of "hamburger thyrotoxicosis" resulting from inadvertent consumption of beef contaminated with bovine thyroid gland have been previously reported. Here we describe a single patient who experienced recurrent episodes of this phenomenon over an 11-year period and present an approach to systematically evaluating patients with recurrent hyperthyroidism.

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Figures

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Fig. 1: Thyroid-stimulating hormone (TSH) and free thyroxine (T4) levels for a 61-year-old woman show 5 documented episodes of transient hyperthyroidism over a period of 11 years, starting in November 1990. Normal levels, indicated by shaded horizontal bars: 0.35 to 5.0 μIU/L for TSH, 9 to 23 pmol/L for free T4.
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Fig. 2: Algorithm showing diagnostic approach to a patient with recurrent hyperthyroidism. sTSH = sensitive TSH.
Box 1
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