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Subacute Granulomatous Thyroiditis: What Patients Need to Know

Learning More about de Quervain's Thyroiditis / Subacute Thyroiditis

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Updated June 12, 2013

The term thyroiditis refers generally to any disorder that involves inflammation of the thyroid. Thyroiditis is typically divided into two broad categories -- painless and painful -- that involve the level of pain they cause to patients.

Among the category of painful types of thyroiditis is a form known as subacute granulomatous thyroiditis. It also is known as subacute nonsuppurative thyroiditis, de Quervain's thyroiditis, or painful subacute thyroiditis.

Symptoms of subacute granulomatous thyroiditis typically include neck pain and tenderness. Some patients experience difficulty swallowing or fever. The cause of the condition is thought to be a virus.

What can you expect if you have subacute granulomatous thyroiditis? Researching more about the condition, I checked out an article that offered an overview of thyroiditis on UpToDate -- an electronic reference used by many physicians and patients that presents in-depth medical information.

"The clinical manifestations are commonly divided into a painful thyrotoxic phase following which thyroid hormone levels return to the normal range. As thyroid hormone stores are depleted, a hypothyroid phase is then observed. Finally, when thyroid gland synthesis and regulation return to normal, so do the serum thyroid hormone levels. Each phase typically lasts about four to six weeks.

"In a follow-up study of 160 patients with subacute granulomatous thyroiditis seen at the Mayo Clinic, only 4 percent of the patients had a recurrence (6 to 21 years after the initial episode). Only 15 percent of patients eventually developed permanent hypothyroidism requiring levothyroxine therapy."

Typically, then, an episode of subacute granulomatous thyroiditis starts out with a period of hyperthyroidism that typically lasts from four to six weeks. Thyroid hormone levels then start to drop, becoming normal for about four weeks and then they continue to decline toward a hypothyroid phase, lasting from four to six weeks.

For treatment, if the primarily complaint is pain or swelling, a non-steroidal anti-inflammatory drug (like aspirin or ibuprofen) may be recommended. If a patient is experiencing significant hyperthyroid symptoms, a beta blocker called propranolol may be prescribed during the hyperthyroid phase of the condition. In some cases, thyroid hormone replacement medications are given during the hypothyroid phase.

Eventually, in most patients, the thyroid gland and hormone production returns to normal.

The good news: Very few patients have a recurrence of subacute granulomatous thyroiditis. The bad news: One long-term study found that in 15 percent of patients, their episode of subacute granulomatous thyroiditis is a sign that they will eventually going permanently hypothyroid, and require treatment.

Want to learn more? See UpToDate's topic, "Overview of thyroiditis," for additional in-depth, medical information

Source:

Burman, Kenneth. Ross, Douglas. Martin, Kathryn. "Overview of thyroiditis." UpToDate. Accessed: August 22, 2008.

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