{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,14]],"date-time":"2025-12-14T08:07:17Z","timestamp":1765699637870,"version":"3.48.0"},"reference-count":11,"publisher":"BMJ","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Clin Pathol"],"published-print":{"date-parts":[[1997,2]]},"abstract":"<jats:p>A case of autoimmune thyroiditis after long term treatment with lithium is described in a 29 year old Japanese woman with manic depression. Positive serum antithyroglobulin and antimicrosomal antibodies, diffuse goitre, and microscopic chronic thyroiditis, as well as the clinical history of long term lithium treatment were suggestive of lithium associated autoimmune thyroiditis. Microscopically, there was a mild degree of interstitial fibrosis and a moderate degree of lymphocytic infiltration. Some areas showed a moderate degree of stromal fibrosis and atrophic thyroid follicles. Lymphoid follicles with germinal centres, disrupted thyroid follicles with lymphocytic infiltration, and H\u00fcrthle cells were also observed. The differential diagnosis in patients presenting with these histological features includes painless (silent) thyroiditis, autoimmune thyroiditis and lithium associated autoimmune thyroiditis. A detailed clinical history is essential if the correct diagnosis is to be reached.<\/jats:p>","DOI":"10.1136\/jcp.50.2.172","type":"journal-article","created":{"date-parts":[[2007,6,9]],"date-time":"2007-06-09T00:50:46Z","timestamp":1181350246000},"page":"172-174","source":"Crossref","is-referenced-by-count":6,"title":["Lithium associated autoimmune thyroiditis."],"prefix":"10.1136","volume":"50","author":[{"given":"M","family":"Shimizu","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M","family":"Hirokawa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"T","family":"Manabe","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"K","family":"Shimozuma","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H","family":"Sonoo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"T","family":"Harada","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[1997,2,1]]},"reference":[{"key":"ref_1","unstructured":"The aetiology of the first two conditions can be explained by the effect of lithium on the thyroid; however, that of hyperthyroidism has been not been explained adequately. Other cases of lithium related thyroid disease have been reported but of a diagnosis of Graves' disease. However, on admission in 1993, the patient had become euthyroid, and diffuse goitre (right lobe 6.5 x 2.3 x 1.7 cm; left lobe 6.5 x 2.0 x 1.5 cm) was observed. Both serum antithyroglobulin and antimicrosomal antibodies were positive at that time. The patient underwent subtotal thyroidectomy for the diffuse goitre.","article-title":"The aetiology of the first two conditions can be explained by the effect of lithium on the thyroid; however, that of hyperthyroidism has been not been explained adequately. Other cases of lithium related thyroid disease have been reported but of a diagnosis of Graves' disease. However, on admission in 1993, the patient had become euthyroid, and diffuse goitre (right lobe 6.5 x 2.3 x 1.7 cm; left lobe 6.5 x 2.0 x 1.5 cm) was observed. Both serum antithyroglobulin and antimicrosomal antibodies were positive at that time. The patient underwent subtotal thyroidectomy for the diffuse goitre"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1001\/jama.1979.03300030043021","article-title":"Lithium carbonate-induced hypothyroidism. Its many faces","volume":"242","author":"Jefferson, J.W.","year":"1979","unstructured":"Jefferson JW. Lithium carbonate-induced hypothyroidism. Its many faces. JAMA 1979;242:271-2.","journal-title":"JAMA"},{"key":"ref_3","first-page":"1245","volume":"80","author":"McDermott, M.T.; Burman, K.D.; Hofeldt, F.D.; Kidd, G.S.","year":"1986","unstructured":"McDermott MT, Burman KD, Hofeldt FD, Kidd GS. Lithium-associated thyrotoxicosis. Am J Med 1986;80: 1245-8.","journal-title":"Lithium-associated thyrotoxicosis. Am J Med"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"582","DOI":"10.1136\/jcp.48.6.582","article-title":"Histological features of the thyroid gland in a patient with lithium induced thyrotoxicosis","volume":"48","author":"Mizukami, Y.; Michigishi, T.; Nonomura, A.; Nakamura, S.; Noguchi, M.; Takazakura, E.","year":"1995","unstructured":"Mizukami Y, Michigishi T, Nonomura A, Nakamura S, Noguchi M, Takazakura E. Histological features of the thyroid gland in a patient with lithium induced thyrotoxicosis. J Clin Pathol 1995;48:582-4.","journal-title":"J Clin Pathol"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1111\/j.1600-0447.1991.tb05523.x","article-title":"Thyroid abnormalities during lithium treatment","volume":"83","author":"Bocchetta, A.; Bernardi, F.; Pedditzi, M.; Loviselli, A.; Velluzzi, F.; Martino, E.","year":"1991","unstructured":"Bocchetta A, Bernardi F, Pedditzi M, Loviselli A, Velluzzi F, Martino E, et al. Thyroid abnormalities during lithium treatment. Acta Psychiatr Scand 1991;83:193-8.","journal-title":"Acta Psychiatr Scand"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1016\/0165-0327(92)90013-V","article-title":"Thyroid abnormalities during chronic lithium treatment in Hong Kong Chinese: a controlled study","volume":"26","author":"Lee S, Chow CC, Wing YK, Shek CC","year":"1992","unstructured":"Lee S, Chow CC, Wing YK, Shek CC. Thyroid abnormalities during chronic lithium treatment in Hong Kong Chinese: a controlled study. JAffect Disord 1992;26:173-8.","journal-title":"JAffect Disord"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"46","DOI":"10.2165\/00002018-199513010-00006","article-title":"Drug-induced thyroid disorders","volume":"13","author":"Gittoes, N.J.L.; Franklyn, J.A.","year":"1995","unstructured":"Gittoes NJL, Franklyn JA. Drug-induced thyroid disorders. 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Hum Pathol 1983;14:737-9.","journal-title":"Hum Pathol"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1318","DOI":"10.1176\/ajp.142.11.1318","article-title":"Autoimmune thyroiditis in manic depressive patients treated with lithium","volume":"142","author":"Calabrese, JR, Gulledge; AD, Hahn; K, Skwerer; R, Kotz; M, Schumacher; O.P.","year":"1985","unstructured":"Calabrese JR, Gulledge AD, Hahn K, Skwerer R, Kotz M, Schumacher OP, et al. Autoimmune thyroiditis in manic depressive patients treated with lithium. Am J Psychiatry 1985;142:1318-21.","journal-title":"Am J Psychiatry"},{"key":"ref_11","first-page":"\"135","article-title":"Pathology of chronic thyroiditis: A new clinically relevant classification","volume":"29","author":"Mizukami, Y.; Michigishi, T.; Nonomura, A.; Nakamura, S.; Ishizaki, T.","year":"1994","unstructured":"Mizukami Y, Michigishi T, Nonomura A, Nakamura S, Ishizaki T. Pathology of chronic thyroiditis: A new clinically relevant classification. 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