Med. praxi. 2022;19(2):139-145 | DOI: 10.36290/med.2022.021

Pitfalls in the diagnosis of subacute or de Quervain's thyroiditis

doc. MUDr. Milan Halenka, Ph.D.

III. interní klinika - nefrologická, revmatologická, endokrinologická, FN a LF UP Olomouc

Subacute thyroiditis, also known as de Quervain's thyroiditis, is a painful inflammation of the thyroid gland. The disease is relatively rare and, despite its typical clinical symptoms, laboratory features and ultrasound findings, correct diagnosis is not always quick and easy. It often follows a previous viral infection of the upper respiratory tract. The most common first symptom is palpable and painful thyroid gland accompanied often by symptoms of hyperthyroidism. The disease should be initially distinguished from prolonged upper respiratory tract infection or other causes of thyrotoxicosis and then appropriate therapy should be started. Substantial is thorough ultrasonographic examination. In addition to elementary laboratory values, it is necessary to diagnose and monitor the effect of treatment. At the beginning of the disease, close and rapid cooperation of a general practitioner, otorhinolaryngologist, sonographer and endocrinologist is needed. The course of the disease can be difficult to predict. Treatment of severe forms requires the administration of glucocorticoids. Serious complications include early relapse with the need to prolong treatment, less often late relapses after years post initial diagnosis. Persistent hypothyroidism can develop even after successful treatment. Therefore, treatment and follow-up should be already in the hands of a specialist - an endocrinologist.

Keywords: subacute thyroiditis, ultrasonography, glucocorticoids, early relapse, late recurrence, persistent hypothyroidism.

Published: May 5, 2022  Show citation