Subacute thyroiditis

Subacute thyroiditis (De Quervain's, granulomatous, giant cell thyroiditis) is a relatively common inflammation of the thyroid gland, occurring more in women. Unlike acute thyroiditis (which has bacterial etiopathogenesis), subacute is most often caused by viruses. The disease often begins immediately or very shortly after a viral infection of the upper respiratory tract.

Clinical picture[edit | edit source]

We find these symptoms:

painful swelling in the thyroid gland that can shoot into the jaw and ear,
general symptoms (fatigue, subfebrile),
symptoms of transient destructive hyperthyroidism (when a large part of the parenchyma is affected) - palpitations, sweating, nervousness.

Diagnostics[edit | edit source]

The basis for diagnosis is the clinical picture of the patient. In the laboratory, we find increased sedimentation and slightly increased CRP. In transient hyperfunction, there is a decrease in TSH and an increase in free-T4. Ultrasound and FNAB are used for imaging methods.

Therapy[edit | edit source]

Treatment consists of anti-inflammatory drugs: the first choice is non-steroidal anti-inflammatory drugs, if the problems do not subside, we give corticoids. Subacute thyroiditis, which affects a large part of the gland volume, can progress to hypothyroidism, then we indicate thyroxine.

Prognosis[edit | edit source]

Most patients are curable, 10% of patients turn into permanent hypothyroidism.

Links

Literature[edit | edit source]

ČEŠKA, Richard – ŠTULC, Tomáš, et al. Interna. 2. edition. 2015. pp. 909. ISBN 978-80-7387-895-5.