{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T14:16:42Z","timestamp":1784557002600,"version":"3.55.0"},"reference-count":7,"publisher":"Bioscientifica","content-domain":{"domain":["edm.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2016,7,28]]},"abstract":"Summary<\/jats:title>\n \n Thyrotoxicosis is an under-recognised but clinically important complication of parathyroidectomy. We report a case of a 37-year-old man with tertiary hyperparathyroidism who initially developed unexplained anxiety, diaphoresis, tachycardia, tremor and hyperreflexia one day after subtotal parathyroidectomy. Thyroid biochemistry revealed suppressed thyroid stimulating hormone and elevated serum free T\n 4<\/jats:sub>\n and free T\n 3<\/jats:sub>\n levels. Technetium-99m scintigraphy scan confirmed diffusely decreased radiotracer uptake consistent with thyroiditis. The patient was diagnosed with thyrotoxicosis resulting from palpation thyroiditis. Administration of oral beta-adrenergic antagonists alleviated his symptoms and there was biochemical evidence of resolution fourteen days later. This case illustrates the need to counsel patients about thyroiditis as one of the potential risks of parathyroid surgery. It also emphasises the need for biochemical surveillance in patients with unexplained symptoms in the post-operative period and may help to minimise further invasive investigations for diagnostic clarification.\n <\/jats:p>\n \n Learning points<\/jats:title>\n \n \n \n Thyroiditis as a complication of parathyroidectomy surgery is uncommon but represents an under-recognised phenomenon.<\/jats:p>\n <\/jats:list-item>\n \n It is thought to occur due to mechanical damage of thyroid follicles by vigorous palpation.<\/jats:p>\n <\/jats:list-item>\n \n Palpation of the thyroid gland may impair the physical integrity of the follicular basement membrane, with consequent development of an inflammatory response.<\/jats:p>\n <\/jats:list-item>\n \n The majority of patients are asymptomatic, however clinically significant thyrotoxicosis occurs in a minority.<\/jats:p>\n <\/jats:list-item>\n \n Patients should be advised of thyroiditis\/thyrotoxicosis as a potential complication of the procedure.<\/jats:p>\n <\/jats:list-item>\n \n Testing of thyroid function should be performed if clinically indicated, particularly if adrenergic symptoms occur post-operatively with no other cause identified.<\/jats:p>\n <\/jats:list-item>\n <\/jats:list>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1530\/edm-16-0049","type":"journal-article","created":{"date-parts":[[2016,7,28]],"date-time":"2016-07-28T10:42:05Z","timestamp":1469702525000},"update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-2","source":"Crossref","is-referenced-by-count":4,"title":["Palpation thyroiditis following subtotal parathyroidectomy for hyperparathyroidism"],"prefix":"10.1530","volume":"2016","author":[{"given":"Elizabeth M","family":"Madill","sequence":"first","affiliation":[{"name":"1Department of Endocrinology and Diabetes, The Alfred Hospital, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shamil D","family":"Cooray","sequence":"additional","affiliation":[{"name":"1Department of Endocrinology and Diabetes, The Alfred Hospital, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leon A","family":"Bach","sequence":"additional","affiliation":[{"name":"1Department of Endocrinology and Diabetes, The Alfred Hospital, Melbourne, Victoria, Australia"},{"name":"2Department of Medicine (Alfred)Monash University, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"416","reference":[{"key":"key20160729170238289_bib1","doi-asserted-by":"crossref","first-page":"27","DOI":"10.3346\/jkms.1988.3.1.27","article-title":"Histopathological study of the so called \u2018palpation thyroditis\u2019","volume":"3","author":"Hwang","year":"1988","journal-title":"Journal of Korean Medical Science"},{"key":"key20160729170238289_bib2","doi-asserted-by":"crossref","first-page":"432","DOI":"10.1007\/s00508-008-0996-3","article-title":"Transient hyperthyroidism after total parathyroidectomy for hyperparathyroidism: a report of two cases","volume":"14","author":"Lederer","year":"2008","journal-title":"Wien Klin Wochenschr"},{"key":"key20160729170238289_bib3","doi-asserted-by":"crossref","first-page":"1058","DOI":"10.1016\/j.surg.2005.09.011","article-title":"Hyperparathyroidism after parathyroid exploration","volume":"138","author":"Stang","year":"2005","journal-title":"Surgery"},{"key":"key20160729170238289_bib4","doi-asserted-by":"crossref","first-page":"656","DOI":"10.4158\/EP09367.CR","article-title":"Parathyroidectomy induced thyroiditis","volume":"16","author":"Espiritu","year":"2010","journal-title":"Endocrine Practice"},{"key":"key20160729170238289_bib5","first-page":"224","article-title":"Post-parathyroidectomy transient thyrotoxicosis","volume":"75","author":"Walfish","year":"1992","journal-title":"Journal of Clinical Endocrinology and Metabolism"},{"key":"key20160729170238289_bib6","doi-asserted-by":"crossref","first-page":"639","DOI":"10.1093\/ajcp\/64.5.639","article-title":"Palpation thyroiditis (multifocal granulomatous folliculitis)","volume":"64","author":"Carney","year":"1975","journal-title":"American Journal of Clinical Pathology"},{"key":"key20160729170238289_bib7","doi-asserted-by":"crossref","first-page":"375","DOI":"10.1186\/2047-783X-16-8-375","article-title":"Isermann B Transient hyperthyroidism after surgery for secondary hyperparathyroidism: a common problem","volume":"16","author":"Rudofsky","year":"2011","journal-title":"European Journal of Medical Research"}],"container-title":["Endocrinology, Diabetes & Metabolism Case Reports"],"original-title":[],"link":[{"URL":"https:\/\/edm.bioscientifica.com\/view\/journals\/edm\/2016\/1\/EDM16-0049.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/edm.bioscientifica.com\/downloadpdf\/journals\/edm\/2016\/1\/EDM16-0049.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T13:46:20Z","timestamp":1784555180000},"score":1,"resource":{"primary":{"URL":"http:\/\/journals.bioscientifica.com\/edm\/article\/3300"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,7,28]]},"references-count":7,"URL":"https:\/\/doi.org\/10.1530\/edm-16-0049","relation":{},"ISSN":["2052-0573"],"issn-type":[{"value":"2052-0573","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,7,28]]}}}