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Subacute thyroiditis

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

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 , or a common cold.

Subacute thyroiditis occurs most often in middle-aged women with recent (within the last month) 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, in rare cases, 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:

  • Diarrhea
  • Hair loss
  • Heat intolerance
  • Irregular menstrual periods in women
  • Mood changes
  • Nervousness
  • Palpitations
  • Sweating
  • Tremor
  • Weight loss

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

  • Cold intolerance
  • Constipation
  • Fatigue

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

Exams and Tests

Laboratory tests that may be done include:

In some cases, thyroid biopsy may be done.

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 drugs called beta-blockers.

Outlook (Prognosis)

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

Possible Complications


  • Permanent hypothyroidism
  • Subacute thyroiditis returns after treatment

When to Contact a Medical Professional

Call your health care provider if:

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

Prevention

Vaccines that prevent viral infections such as the flu may help prevent subacute thyroiditis. Other causes may not be preventable.

References

Mandel SJ, Larsen PR, Davies TF. Thyrotoxicosis. In: Melmed S, Polonsky KS, Larsen PR, Kronenberg HM, eds. Williams Textbook of Endocrinology. 12th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 12.

Updated: 5/10/2014

Brent Wisse, MD, Associate Professor of Medicine, Division of Metabolism, Endocrinology & Nutrition, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.


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