1.A Case of Subacute Thyroiditis Satisfactorily Treated with Kampo-therapy
Yoshiro HIRASAKI ; Hiroshi OKA ; Susumu TETSUMURA ; Ryousuke OBI ; Hideo KIMURA ; Kazufumi KOUTA ; Tadamichi MITSUMA
Kampo Medicine 2004;55(3):319-324
We report the case of a 77-year-old female with subacute thyroiditis who was successfully treated with traditional herbal medicine (Kampo-therapy). On 18th December 2001, the patient was admitted to our hospital because of malaise and loss of appetite.
The patient complained of what she thought was a sore throat that began one month prior to admission, with a fever rising to 37.8°C 4 days before admission. Physical examination showed tenderness and swelling of the thyroid. Blood examination showed hyperthyroidism (TSH 0.02μIU/ml fT3 20.18ng/dl fT4 5.21ng/dl) and high inflammation (CRP 13.7 ESR 122mm/hr). We then diagnosed subacute thyroiditis and treated her with Kampo-therapy only. We arranged herbs according to the “Sho-kan-ron (_??__??__??_)” and gave her Keishi-ni-eppi-ichi-to (_??__??__??__??__??__??__??_) and Choi-joki-to (_??__??__??__??__??_). Four days after admission, her intermittent fever disappeared. After 10 days, her CRP became negative. After 13 days, almost all the symptoms had disappeared. Thyroid function (fT3, fT4) returned to normal after 17 days of Kampo-therapy. Subacute thyroiditis is a self limiting disease, but steroid therapy is often needed to reduce the symptoms and avoid thyrotoxicosis. In this case, the patient made a relatively quick recovery without steroid therapy. We suggest Kampo-therapy can be an effective treatment for subacute thyroiditis.