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Subacute Thyroiditis (de Quervain's)

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Topic updated on 04/09/17 7:31pm

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
  • 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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Qbank (1 Questions)

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(M1.EC.94) A 40-year-old female presents to your office complaining of a tender neck and general lethargy. Upon further questioning, she reports decreased appetite, fatigue, constipation, and jaw pain. Her pulse is 60 bpm and her blood pressure is 130/110 mm Hg. Biopsy of her thyroid reveals granulomatous inflammation and multinucleate giant cells surrounding fragmented colloid. Which of the following likely precipitated the patient’s condition: Topic Review Topic

1. Iodine deficiency
2. Goitrogens
3. Thryoglossal duct cyst
4. Infection
5. Chronic renal disease

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