What is Subacute thyroiditis (De Quervain’s Thyroiditis)

Subacute thyroiditis or De Quervain’s Thyroiditis is a disease of the Thyroid Gland.

Statistics on Subacute thyroiditis (De Quervain’s Thyroiditis)

Peak incidence 2nd to 5th decades with female predominance ( 3:1)

Risk Factors for Subacute thyroiditis (De Quervain’s Thyroiditis)

 

  • Believed to be an inflammatory immune reaction.
  • Frequently, there is a history of an antecedent viral upper respiratory tract infection.

 

Progression of Subacute thyroiditis (De Quervain’s Thyroiditis)

Hyperthyroidism is common early in the disease because of hormone release from the disrupted follicles. Subsequently hypothyroidism sets in as the release of thyroid hormone abates and there are less functional glands. There is more lassitude and prostration than in other thyroid disorders.

How is Subacute thyroiditis (De Quervain’s Thyroiditis) Diagnosed?

Laboratory findings early in the disease include an increase in T4 and T3, a decrease in TSH and the thyroid radioactive iodine uptake (often 0), and a high ESR.

Prognosis of Subacute thyroiditis (De Quervain’s Thyroiditis)

Subacute thyroiditis is self-limited, generally subsiding in a few months; occasionally it recurs and may result in permanent hypothyroidism when there is extensive follicular destruction. Recurrences are uncommon.

How is Subacute thyroiditis (De Quervain’s Thyroiditis) Treated?

Treatment consists of high doses of aspirin or NSAIDs. In more severe and protracted cases, corticosteroids (e.g. 30 to 40 mg prednisone daily, gradually decreasing the dose over 6 wk) are recommended and will abort all symptoms within 24 to 48 hours.

Treatment should be discontinued when the thyroid radioactive iodine uptake returns to normal or reaches elevated levels. A few patients will become hypothyroid once the inflammation settles down and therefore will need to stay on thyroid hormone replacement indefinitely.

Subacute thyroiditis (De Quervain’s Thyroiditis) References

[1] Ballinger, A. Patchett, S., Saunders’ Pocket Essentials of Clinical Medicine 2nd ed. W.B. Saunders, 2000.
[2] Kumar P, Clark M. CLINICAL MEDICINE. WB Saunders 2002.
[3] Longmore M, Wilkinson I, Torok E. OXFORD HANDBOOK OF CLINICAL MEDICINE. Oxford Universtiy Press. 2001.
[4] Robbins, S.L., Cotran, R.S., Kumar, V. Robbins Pathologic Basis of Disease 5th ed. W.B. Saunders 1995.
[5] Subacute Thyroiditis as retrieved from www.merck.com.gov on 18/12/2003.