PMC3962324_01
Clinical course and the changes in free thyroxine (T4), free triiodothyronine (T3), and thyroid-stimulating hormone (TSH). Symptoms such as increased sweating, palpitations, and shortness of breath slowly improved with the spontaneous resolution of hyperthyroidism. However, valsartan quickly resolved pretibial pitting edema shortly after the administration, and there were no further signs of recurrence with the continuous administration of the drug. T4 - thyroxine; T3 - triiodothyronine; TSH - thyroid-stimulating hormone.
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However, since the patient presented systolic hypertension, and since the renin-angiotensin-aldosterone system was thought to be activated, oral administration of an angiotensin II receptor blocker, valsartan (40 mg/day), was immediately started after the diagnosis (Figure 1). Within a few days after the initiation of the drug, the patient's pretibial pitting edema quickly disappeared without any recurrence afterwards (Figure 1), indicating complete remission of the symptom. In contrast, however, other symptoms that are characteristic of hyperthyroidism, such as increased sweating, palpitations, and shortness of breath, slowly improved with the spontaneous resolution of the disease (Figure 1). After 7-month follow-up, her TSH level returned to within the normal range (0.57 muIU/ml) (Figure 1), which was not followed by a hypothyroidic phase thereafter, although it is often the case with silent thyroiditis.