Updated: 1/21/2020

Subacute Thyroiditis (de Quervain)

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Introduction
  • Self-limiting hypothyroidism following a viral infection (URI) 
    • early on may be hyperthyroid (similar to Hashimoto's)
    • later, symptomatology is hypothyroid (though this is not permanent)
Presentation
  • Physical exam
    • jaw pain
    • very tender thyroid gland 
      • post-partum lymphocytic subacute thyroiditis is painless
    • no cervical adenopathy
Evaluation
  • Labs
    • ↑ ESR
  • Histology
    • granulomatous inflammation 
  • 123I uptake
    • decreased
Treatment
  • Manage symptoms (pain) with NSAIDS and aspirin
  • Does not require treatment
Prognosis, Prevention, and Complications
  • Rare to progress to permanent hypothyroidism

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Questions (3)
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(M1.EC.13.94) A 40-year-old female presents to your office complaining of a tender neck and general lethargy. Upon further questioning, she reports decreased appetite, fatigue, constipation, and jaw pain. Her pulse is 60 bpm and her blood pressure is 130/110 mm Hg. Biopsy of her thyroid reveals granulomatous inflammation and multinucleate giant cells surrounding fragmented colloid. Which of the following likely precipitated the patient’s condition:

QID: 100395
1

Iodine deficiency

9%

(2/23)

2

Goitrogens

0%

(0/23)

3

Thryoglossal duct cyst

4%

(1/23)

4

Infection

87%

(20/23)

5

Chronic renal disease

0%

(0/23)

M 2 D

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Evidence (1)
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