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ALL / Endocrinology

Subacute (De Quervain's) thyroiditis

Subacute (De Quervain's) thyroiditis

Subacute thyroiditis (also known as De Quervain's thyroiditis and subacute granulomatous thyroiditis) is thought to occur following viral infection and typically presents with hyperthyroidism.

There are typically 4 phases;
  • phase 1 (lasts 3-6 weeks): hyperthyroidism, painful goitre, raised ESR
  • phase 2 (1-3 weeks): euthyroid
  • phase 3 (weeks - months): hypothyroidism
  • phase 4: thyroid structure and function goes back to normal

Investigations
  • thyroid scintigraphy: globally reduced uptake of iodine-131

Management
  • usually self-limiting - most patients do not require treatment
  • thyroid pain may respond to aspirin or other NSAIDs
  • in more severe cases steroids are used, particularly if hypothyroidism develops

Venn diagram showing how different causes of thyroid dysfunction may manifest. Note how many causes of hypothyroidism may have an initial thyrotoxic phase.
+PassMedicine Notes

Subacute thyroiditis (also known as De Quervain's thyroiditis and subacute granulomatous thyroiditis) is thought to occur following viral infection and typically presents with hyperthyroidism.

There are typically 4 phases;
  • phase 1 (lasts 3-6 weeks): hyperthyroidism, painful goitre, raised ESR
  • phase 2 (1-3 weeks): euthyroid
  • phase 3 (weeks - months): hypothyroidism
  • phase 4: thyroid structure and function goes back to normal
Investigations
  • thyroid scintigraphy: globally reduced uptake of iodine-131
Management
  • usually self-limiting - most patients do not require treatment
  • thyroid pain may respond to aspirin or other NSAIDs
  • in more severe cases steroids are used, particularly if hypothyroidism develops
pdd917.png Venn diagram showing how different causes of thyroid dysfunction may manifest. Note how many causes of hypothyroidism may have an initial thyrotoxic phase.

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