Patient Education - Endocrine Encyclopedia
Endocrine Surgery Encyclopedia
Definition:
Subacute thyroiditis involves inflammation of the thyroid gland that usually follows
an upper respiratory infection and then subsides.
Alternative Names: deQuervain's thyroiditis; Granulomatous giant cell thyroiditis
Causes, incidence, and risk factors:
Subacute thyroiditis is an uncommon condition thought to be caused by viral infection
of the thyroid gland. The condition often occurs after a viral infection of the upper
respiratory tract. Mumps virus, influenza virus, and other respiratory viruses have
been found to cause subacute thyroiditis.
The most prominent feature of subacute thyroiditis is gradual or sudden onset
of pain in the region of the thyroid gland. Painful enlargement of the thyroid gland
may persist for weeks or months. The condition is sometimes associated with fever.
Hoarseness or difficulty swallowing may also develop.
Symptoms of thyroid hormone excess (hyperthyroidism) such as nervousness, rapid
heart rate, and heat intolerance may be present early in the disease. Later, symptoms
of too little thyroid hormone (hypothyroidism) such as fatigue, constipation, or
cold intolerance may occur. Eventually, thyroid gland function returns to normal.
Subacute thyroiditis occurs most often in middle-aged women with recent symptoms
of viral respiratory tract infection.
Symptoms:
- pain in the front of the neck
- tenderness when gentle pressure is applied to the thyroid gland (palpation)
- fever
- weakness
- fatigue
Other symptoms may include:
- nervousness
- heat intolerance
- weight loss
- sweating
- diarrhea
- tremor
- palpitations
Signs and tests:
Laboratory tests in the early phase of disease may reveal:
- High serum thyroglobulin level
- Low radioactive iodine uptake
- Low serum thyroid stimulating hormone (TSH) level
- High serum free T4 (thyroid hormone, thyroxine) level
- High erythrocyte sedimentation rate (ESR)
Laboratory tests in the later phase of disease may show:
- High serum TSH level
- Low serum free T4
Anti-thyroid antibodies are either undetectable or present
at low levels. Thyroid gland biopsy shows characteristic "giant cell" inflammation.
Laboratory abnormalities return to normal as the condition resolves.
Treatment:
The purpose of treatment is to reduce pain and inflammation and to treat any hyperthyroidism,
if present. Anti-inflammatory medications such as aspirin or ibuprofen are used to
control pain in mild cases of subacute thyroiditis.
More serious cases may require temporary treatment with steroids (for example,
prednisone) to control inflammation. Symptoms of hyperthyroidism are treated with
a class of medications called beta-blockers (for example, propranolol, atenolol).
Support Groups:
Expectations (prognosis):
Spontaneous improvement is the rule, but the illness may persist for months. Long-term
or severe complications do not usually occur.
Complications:
relapse of subacute thyroiditis
Calling your health care provider:
Call your health care provider if symptoms of this disorder occur. Also call if you
have thyroiditis and symptoms do not improve with treatment.
Prevention:
MMR (measles, mumps, rubella) immunization (vaccine) or flu vaccine may be helpful
to prevent these causes. Other causes may not be preventable.
Review Date: 4/19/2004
Reviewed By: Nancy J. Rennert, M.D., Endocrinology, Yale University School of Medicine,
New Haven, CT. Review provided by VeriMed Healthcare Network.
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