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Updated: Feb 13 2022

Subacute Thyroiditis (de Quervain)

  • 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
      • hyperthyroid phase: high T4, high T3, low TSH
      • euthyroid phase: normal T4, T3, TSH
      • hypothyroid phase: normal/low T4 and T3, elevated TSH
    • 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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