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Highlights & Basics
- Subacute thyroiditis (also termed De Quervain thyroiditis, granulomatous thyroiditis, or giant cell thyroiditis) is a self-limited inflammation of the thyroid gland. No specific therapy is generally necessary.
- It is characterized by a triphasic course of transient thyrotoxicosis, followed by hypothyroidism, and then return to euthyroidism.
- The thyrotoxic phase is due to thyroid follicular damage and release of preformed thyroid hormones into the circulation. This phase is characterized by very low radioactive iodine uptake by the thyroid.
- Moderate-to-severe neck pain and tenderness, which may be migratory and affect different areas of the thyroid gland at different times, is typical of the thyrotoxic phase. The thyroid is often enlarged, firm, and tender to palpation.
- Ultrasound of the thyroid may show areas of hypoechogenicity with decreased or normal vascular flow by Doppler.
Quick Reference
History & Exam
Key Factors
Other Factors
Diagnostics Tests
Treatment Options
Definition
Epidemiology
Etiology
Pathophysiology
Images
I-123 radioactive iodine scan showing absence of thyroid uptake in the thyrotoxic phase of subacute thyroiditis arrow indicates sternal notch marker
Clinical course of subacute thyroiditis: measurements of serum TSH, serum T4, and I-123 thyroid uptake during thyrotoxic, hypothyroid, and euthyroid phases
Citations
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Stasiak M, Lewiński A. New aspects in the pathogenesis and management of subacute thyroiditis. Rev Endocr Metab Disord. 2021 Dec;22(4):1027-39.[Abstract][Full Text]
Ross DS, Burch HB, Cooper DS, et al. 2016 American Thyroid Association guidelines for diagnosis and management of hyperthyroidism and other causes of thyrotoxicosis. Thyroid. 2016 Oct;26(10):1343-421.[Abstract][Full Text]
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