The Basics of Subacute Thyroiditis

Inflammatory diseases are some of the most common thyroid conditions encountered in the clinical setting. These types of thyroiditis are classified under three main categories – acute, subacute, and chronic. This article will discuss Subacute Thyroiditis.

What is Subacute Thyroiditis?

Subacute Thyroiditis category includes granulomatous or De Quervain’s Thyroiditis and lymphocytic thyroiditis (also called silent thyroiditis).

De Quarvain’s Thyroiditis was first described in 1904 while Silent Thyroiditis was recognized only in 1970. These subacute forms of thyroiditis are characterized by the painful and tender swelling of the thyroid gland. The swelling happens at a very rapid rate, as seen in a case study[1] of a forty (40) year old female made by Bhadauria et.al shared by the US National Library of Medicine.

Other subacute thyroiditis subtypes are Postpartum Thyroiditis (occurs within a year of childbirth) and Palpation Thyroiditis (damage due to mechanical manipulation such as surgery), as per Healthline.[2] It is sometimes misconstrued as similar to Hashimoto’s Thyroiditis (part of the chronic category) but this is far less common.

Causes of Subacute Thyroiditis

According to The University of Pennsylvania, while it is an uncommon condition, it is believed to be a result of a viral infection of the ear or throat and is most often seen in middle-aged women following a respiratory tract infection.[3]

Symptoms of Subacute Thyroiditis

The most striking symptom of Subacute Thyroiditis, as per UCLA Health is the onset of pain in the neck, specifically in the thyroid gland area.[4] This is followed by an excruciating enlargement of the thyroid gland that may go on for weeks or even months. Understandably, a patient with this disease may experience hoarseness of voice, painful swallowing (odynophagia) and fever.

Other symptoms present in hyperthyroidism (overactive thyroid) such as rapid heart rate and palpitations may also be seen at the onset of subacute thyroiditis while as it progresses, symptoms of hypothyroidism (underactive thyroid) will be observed such as fatigue and constipation.

Possible Treatment for Subacute Thyroiditis

Laboratory tests may be undergone to check whether the Thyroid Stimulating Hormone (TSH) is at a low or high level, depending on the phase of the disease. Anti-thyroid antibodies may also be present but otherwise undetectable but a biopsy will be able to show an inflammation of a “giant cell”.

Dr James Norman wrote for EndocrineWeb that treatment usually involves first aids like bed rest and a dose of aspirin to lessen the inflammation on the thyroid area.[5] Steroids such as cortisone as well as thyroid hormone therapy may also be used should the condition be at a prolonged state.

The best part is that reoccurrences are rare and that almost all patients recover from Subacute Thyroiditis. The thyroid gland would return to normal status after a few weeks or months though some patients would develop hypothyroidism. Hormone replacement therapy can help control the hypothyroidism symptoms leading patients to live a relatively normal life.

[1] De Quervain's Thyroiditis. Bhadauria RS, Nema SK, Kumar P. (2011 July 21). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4923540/

[2] Subacute Thyroiditis. Healthline. https://www.healthline.com/health/subacute-thyroiditis

[3] Subacute Thyroiditis. Penn Medicine, University of Pennsylvania. https://www.pennmedicine.org/for-patients-and-visitors/patient-information/conditions-treated-a-to-z/subacute-thyroiditis

[4] Subacute Thyroiditis. UCLA Health. https://www.uclahealth.org/endocrine-center/subacute-thyroiditis

[5] What is Thyroiditis? Norman J. (2018 November 20). https://www.endocrineweb.com/conditions/thyroid/thyroiditis

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