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Endocrine glands
Endocrine glands


Thyroid gland
Thyroid gland


Definition:

Subacute thyroiditis involves swelling (inflammation) of the thyroid gland that usually follows an upper respiratory infection.



Alternative Names:

De Quervain's thyroiditis; Subacute nonsuppurative thyroiditis; Giant cell thyroiditis; Subacute granulomatous thyroiditis



Causes, incidence, and risk factors:

Subacute thyroiditis is a rare condition. It is thought to be caused by a viral infection. The condition often occurs after a viral infection of the upper respiratory tract, such as mumps and influenza .

Subacute thyroiditis occurs most often in middle-aged women with recent symptoms of a viral respiratory tract infection.



Symptoms:

The most obvious symptom of subacute thyroiditis is pain in the neck. Sometimes the pain can spread (radiate) to the jaw or ears. Painful enlargement of the thyroid gland may last for weeks or months.

Other symptoms include:

  • Difficulty swallowing
  • Fatigue
  • Fever
  • Hoarseness
  • Tenderness when gentle pressure is applied to the thyroid gland (palpation )
  • Weakness

Symptoms of too much thyroid hormone (hyperthyroidism ) may include:

Later, symptoms of too little thyroid hormone (hypothyroidism) may occur, including:

  • Cold intolerance
  • Constipation
  • Fatigue

Usually thyroid gland function returns to normal. But in some cases hypothyroidism may be permanent.



Signs and tests:

Laboratory tests early in the course of the disease may show:

Laboratory tests later in the disease may show:

  • High serum TSH level
  • Low serum free T4

There may be low levels of antithyroid antibodies. Thyroid gland biopsy is usually not needed, but will show a type of inflammation characteristic of this condition. Lab tests should return to normal as the condition goes away.



Treatment:

The purpose of treatment is to reduce pain and inflammation and treat hyperthyroidism, if it occurs. Anti-inflammatory medications such as aspirin or ibuprofen are used to control pain in mild cases.

More serious cases may need 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). Antithyroid drugs or thionamides are not effective in treating this condition.



Support Groups:



Expectations (prognosis):

The condition should improve on its own. However, the illness may last for months. Long-term or severe complications do not usually occur.



Complications:
  • Permanent hypothyroidism
  • Subacute thyroiditis returns after treatment


Calling your health care provider:

Call your health care provider if:

  • You have symptoms of this disorder
  • You have thyroiditis and symptoms do not improve with treatment


Prevention:

MMR (measles, mumps, rubella) immunization (vaccine) or flu vaccine may help prevent these conditions, which can cause subacute thyroiditis. Other causes may not be preventable.



References:

Ladenson P, Kim M. Thyroid. In: Goldman L and Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders; 2007:chap 244.




Review Date: 6/17/2008
Reviewed By: Elizabeth H. Holt, MD, PhD, Assistant Professor of Medicine, Section of Endocrinology and Metabolism, Yale University. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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789 Central Avenue, Dover, NH 03820
Phone: (603) 742-5252
Toll free: 1 (877) 201-7100