Informing & Supporting Thyroid Patients Since 1985
Informing & Supporting Thyroid Patients Since 1985
Thyroid Research 
Thyroid Research Archive Thyroiditis
(July 2003)
The background of the study. Subacute granulomatous thyroiditis (de Quervain's thyroiditis) is characterized by thyroid pain and tenderness, symptoms of inflammation, and transient hyperthyroidism and hypothyroidism. This study was done to determine the characteristics and outcome of this disorder.
How the study was done. Cases of subacute granulomatous thyroiditis (hereafter referred to as subacute thyroiditis) were identified from the records of residents of Olmsted County, Minnesota. The inclusion criteria were thyroid pain and a low thyroid radioiodine uptake or high erythrocyte sedimentation rate, or a pathological diagnosis of the disorder. The records were reviewed through 1997, and interviews were conducted if no recent information was available.
The results of the study. There were 160 cases of subacute thyroiditis between 1960 and 1997. The clinical findings were evaluated in the 94 cases seen between 1970 and 1997; 73 were women and 21 were men (average age, 46 years). The findings were: upper respiratory infection before thyroiditis, 20 patients (21 percent); thyroid pain, 91 patients (97 percent); difficulty swallowing, 30 patients (32 percent); and thyroid tenderness, 89 patients (95 percent). The thyroid gland was normal in size in 19 patients and enlarged in 57 patients. Many patients had high serum free thyroxine and low serum thyrotropin (TSH) concentrations, and nearly all patients had a low thyroid radioiodine uptake and a high erythrocyte sedimentation rate. The patients were treated with prednisone, a nonsteroidal anti-inflammatory drug, or both, or acetaminophen. The mean time to resolution of thyroid pain was four days in the patients treated with prednisone and 35 days in those treated with a nonsteroidal anti-inflammatory drug.
Nine patients (10 percent) had a recurrence of symptomatic thyroiditis within 6 to 12 months, and 4 patients (4 percent) had a recurrence 6 to 21 years later. Twenty-seven patients (29 percent) had a high serum TSH concentration in the first year after diagnosis; 9 were being treated with thyroxine at last follow-up. Hypothyroidism occurred 2 to 24 years later in 5 patients (5 percent).
The conclusions of the study. Late recurrence and permanent hypothyroidism are rare in patients with subacute thyroiditis.
The original article. Fatourechi V, Aniszewski JP, Fatourechi GZ, Atkinson EJ, Jacobsen SJ. Clinical features and outcome of subacute thyroiditis in an incidence cohort: Olmsted County, Minnesota, study. J Clin Endocrinol Metab 2003;88:2100-5.
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