[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-452860-105":59,"doc-detail-452860-en":130},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":123,"head_meta":125,"extra_data":127,"updated_unix":129},105,"en","severe-headache-as-the-initial-manifestation-of-painless-thyroiditis-a-pediatric-case-report","Severe headache as the initial manifestation of painless thyroiditis: a pediatric case report","","Painless thyroiditis can cause transient thyrotoxicosis, usually accompanied by weakness, fatigue, irritability, palpitations, and tremors, but headache is an uncommon presenting feature. Two 14-year-old boys presented with severe migraine-like headaches without typical thyrotoxicosis symptoms. Brain imaging showed no abnormalities, while blood tests revealed elevated thyroid hormones and suppressed thyroid-stimulating hormone. Both were diagnosed via absence of thyroid pain and increased thyroid blood flow on ultrasonography and treated symptomatically as outpatients.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/severe-headache-as-the-initial-manifestation-of-painless-thyroiditis-a-pediatric-case-report/452860/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/severe-headache-as-the-initial-manifestation-of-painless-thyroiditis-a-pediatric-case-report/452860.png","ImageObject",300,407,{"name":92,"@type":93},"moss~","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-30","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":44},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"Why can painless thyroiditis present with severe headache in children?","Question",{"text":112,"@type":113},"The case report describes headache as an initial symptom of painless thyroiditis, with thyrotoxicosis detected through thyroid hormone abnormalities even when classic symptoms are absent.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How are the patients diagnosed in the report?",{"text":117,"@type":113},"Diagnosis was based on the absence of thyroid pain, increased thyroid blood flow on thyroid ultrasonography, and blood tests showing elevated thyroid hormones with suppressed thyroid-stimulating hormone.",{"name":119,"@type":110,"acceptedAnswer":120},"What happens to thyroid hormone levels and headache over time?",{"text":121,"@type":113},"Thyroid hormone levels normalized spontaneously within a few months, and the patients’ headaches improved accordingly.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},452860,1790765089,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":44,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":34,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":144,"preview_page_count":4},962090895452,"https://ap-avatar.wpscdn.com/davatar_a8503ba1806abce46bf441b54a3ca4cd","Clinical Pediatric Endocrinology  \nVol.35 / No.1 January 2026 pp 85–91  \nCase Report  \nSevere headache as the initial manifestation of painless thyroiditis: a pediatric case report  \nRisa Nagase1 , Yuki Kawashima1, 2 , MariAsakura1 , Masashi Ogasawara1, 3 , Kunihiro Oba1 , and Masahiro Noda1  \n1Department of Pediatrics, Showa General Hospital, Tokyo, Japan  \n2Department of Pediatrics, The University of Tokyo Hospital, Tokyo, Japan  \n3Department of Neuromuscular Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry (NCNP), Tokyo, Japan  \nHighlights  \n● We report two cases of painless thyroiditis in which headache was the initial presenting symptom.  \n● Headache could be one of the symptoms of thyrotoxicosis.  \n● Measuring thyroid hormone levels in patients with unexplained severe headaches may aid in proper diagnosis.  \nAbstract. Painless thyroiditis is a potential cause of thyrotoxicosis, typically presenting with weakness, fatigue, irritability, palpitations, and tremors; however, headache is an uncommon manifestation. Herein, we report two pediatric cases of painless thyroiditis in which headache was the initial presenting symptom. Two 14-yr-old boys presented to our emergency department with chief complaints of severe migraine-like headaches. They did not exhibit typical symptoms of thyrotoxicosis. Head imaging findings revealed no abnormalities, and blood test results indicated elevated thyroid hormone and suppressed thyroid-stimulating hormone levels. Both patients were diagnosed with painless thyroiditis based on the absence of thyroid pain and increased blood flow on thyroid ultrasonography, and were monitored on an outpatient basis with only symptomatic treatment. One patient experienced palpitations and required treatment with propranolol. Within a few months, thyroid hormone levels normalized spontaneously in both patients, and their headaches improved accordingly. Although the mechanism by which thyroid hormones cause headaches remains unclear, these two cases suggest that thyrotoxicosis may be associated with headaches. Thus, it is important to measure thyroid hormone levels inpatients with severe headaches without an obvious cause. Furthermore, early detection of thyrotoxicosis may be possible, leading to appropriate treatment, prediction of the future course of the patient’s headache, and relief of the patients’ and parents’ anxiety levels.  \nKey words: painless thyroiditis, severe headache, thyroid hormone, thyrotoxicosis  \nReceived: March 19, 2025 Accepted: August 1, 2025 Advanced Epub: August 31, 2025  \nCorresponding author: Masahiro Noda, M.D., M.P.H., Ph.D., Department of Pediatrics, Showa General Hospital, 8-1-1 Hanakoganei, Kodaira, Tokyo 187-8510, Japan  \n[E-mail: masa.noda5279@gmail.com](E-mail: masa.noda5279@gmail.com)  \nThis is an open-access article distributed under the terms of the Creative Commons Attribution NonCommercial No Derivatives (by-nc-nd) License \u003C[http://creativecommons.org/licenses/by-nc-nd/4.0/](http://creativecommons.org/licenses/by-nc-nd/4.0/)> .  \nCopyright© 2026 by The Japanese Society for Pediatric Endocrinology  \nClin Pediatr Endocrinol 86  \nIntroduction  \nClassically, thyrotoxicosis includes all conditions involving excess thyroid hormones, whereas hyperthyroidism specifically refers to excess thyroid hormone levels from increased thyroid hormone synthesis. Thyrotoxicosis may result from follicular destruction due to thyroiditis or excessive exogenous thyroid hormone intake, and may encompass hyperthyroidism (1, 2) . Although hyperthyroidism and thyrotoxicosis are used interchangeably sometimes (3), we have adhered to the classic definitions outlined above.  \nPainless thyroiditis is a condition in which the thyroid gland cells deteriorate for some reason, leading to the release of thyroid hormone into the bloodstream, resulting in transient thyrotoxicosis (1) . It is termed“painless thyroiditis,” because of the absence of pain during cellular ","cbCaiuMUhNHJYxEy","https://ap.wps.com/l/cbCaiuMUhNHJYxEy","pdf",1467985,"English","# Introduction\n# Case Presentation\n## Case 1","[{\"question\":\"Why can painless thyroiditis present with severe headache in children?\",\"answer\":\"The case report describes headache as an initial symptom of painless thyroiditis, with thyrotoxicosis detected through thyroid hormone abnormalities even when classic symptoms are absent.\"},{\"question\":\"How are the patients diagnosed in the report?\",\"answer\":\"Diagnosis was based on the absence of thyroid pain, increased thyroid blood flow on thyroid ultrasonography, and blood tests showing elevated thyroid hormones with suppressed thyroid-stimulating hormone.\"},{\"question\":\"What happens to thyroid hormone levels and headache over time?\",\"answer\":\"Thyroid hormone levels normalized spontaneously within a few months, and the patients’ headaches improved accordingly.\"}]","Severe headache as the initial manifestation of painless thyroiditis: a pediatric case report | PDF",1790737783,18]