- De Quervain's thyroiditis
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De Quervain's thyroiditis Classification and external resources ICD-10 E06.1 ICD-9 245.1 DiseasesDB 3474 eMedicine med/534 MeSH D013968 de Quervain's thyroiditis, can also be known as subacute granulomatous thyroiditis or Giant Cell Thyroiditis. Males and females of all ages are affected. It is a member of the group of thyroiditis conditions known as resolving thyroiditis.
Contents
Terminology
It is sometimes called subacute thyroiditis,[1] but there is another form of subacute thyroiditis, subacute lymphocytic thyroiditis.
It is also sometimes called "painful subacute thyroiditis".[2] This is in contrast to subacute lymphocytic thyroiditis, which is also sometimes called "painless thyroiditis".
Causes
Some cases may be viral in origin, perhaps preceded by an upper respiratory tract infection. Viral causes include Coxsackie virus, mumps and adenoviruses. Some cases develop postpartum.
Presentation
Patients will experience a hyperthyroid period as the cellular lining of colloid spaces fails, allowing abundant colloid into the circulation, with neck pain and fever. Patients typically then become hypothyroid as the pituitary reduces TSH production and the inappropriately released colloid is depleted before resolving to euthyroid. The symptoms are those of hyperthyroidism and hypothyroidism. In addition, patients may suffer from painful dysphagia. There are multi-nucleated giant cells on histology. Thyroid antibodies can be present in some cases. The clinical presentation during the hyperthyroid phase can mimc that of diffuse toxic goiter (Grave's disease). In such cases, a radionuclide thyroid uptake and scan can be helpful, since subacute thyroiditis will result in decreased isotope uptake, while Grave's disease will generally result in increased uptake. Distinguishing between these two diseases is important, since Grave's disease can be treated with radioiodine therapy, but subacute thyroiditis is usually self-limited and is not treated with radioiodine.
Treatment
Treatment is beta blockers and NSAID (corticosteroids if NSAID ineffective).
Eponym
It is named for Fritz de Quervain.[3] It should not be confused with DeQuervain's syndrome.
References
- ^ Topuzovic N, Smoje J, Karner I (October 1997). "The therapeutic approach in subacute (de Quervain's) thyroiditis". J. Nucl. Med. 38 (10): 1665. PMID 9379217. http://jnm.snmjournals.org/cgi/pmidlookup?view=long&pmid=9379217.
- ^ Peter SA (October 1992). "Painful subacute thyroiditis (de Quervain's thyroiditis)". J Natl Med Assoc 84 (10): 877–9. PMC 2571803. PMID 1404465. http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=2571803.
- ^ synd/1139 at Who Named It?
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