Subacute thyroditis a review
Journal Title: Journal of the Indian Medical Association - Year 2018, Vol 116, Issue 5
Abstract
Subacute thyroiditis (SAT), also known as de Quervain’s thyroiditis, is an important self-limiting cause of thyrotoxicosis. It is possibly a sequel of viral infection and histologically characterized by multinucleated giant cells around a colloid core along with neutrophil and lymphocyte infiltration. It affects both female and male (F:M 5:1) in their 3rd and 4th decade and clinically presents as fever, painful thyroid enlargement with other features of thyrotoxicosis such as weight loss, tremors, excessive perspiration and hyper-defecation. The course of disease is usually predictable, initial thyrotoxic phase (6-8 weeks) followed by short euthyroid phase (1-2 weeks) and hypothyroid phase (6-8 weeks) to complete recovery and restoration of euthyroidism. It is important to differentiate SAT from other causes of thyrotoxicosis as management strategy and prognosis differs significantly. Management in thyrotoxicsis phase includes pain management (NSAIDS or steroids) and ameliorating symptoms of thyrotoxicosis (beta blocker). There is no role of thionamides (Carbimazole or Methimazole) in management of Thyrotoxicosis due to SAT. Cautious short term levothyroxine supplement can be given in hypothyroid stage only if TSH >10 mIU/L and/or presence of symptoms. Usually long term prognosis is excellent.
Authors and Affiliations
Om J Lakhani, Subhodip Pramanik
Keywords
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