Hashitoxicosis is thyrotoxicosis in a patient with Hashimoto's thyroiditis. While Hashimoto's disease is often associated with hypothyroidism, hyperthyroidism can occur.


(1) autoimmune thyroiditis with serum autoantibodies to one or more thyroid antigens

(2) Grave's disease with hyperthyroidism

(3) variable goiter

(4) lymphocytic thyroiditis consistent with Hashimoto's disease


Hashimoto's disease is usually associated with anti-thyroid peroxidase and anti-thyroglobulin autoantibodies. Grave's disease is usually associated with antibodies to TSH receptor.


It may present in pediatric patients.


The thyrotoxicosis is often transient. It reflects excess release of thyroid hormone due to thyroiditis. As the thyroiditis progresses most patients eventually become hypothyroid.



(1) encephalopathy

(2) pericardial effusion

(3) autoantibody-induced interference with thyroid tests

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