Overview
What are forms of subacute thyroiditis?
What is the clinical course of subacute thyroiditis?
What is subacute granulomatous thyroiditis?
What is the pathophysiology of subacute thyroiditis?
What is the role of thyrotoxicosis in the pathophysiology of subacute thyroiditis?
What are the signs and symptoms of thyrotoxicosis in subacute thyroiditis?
What is the prevalence of papillary thyroid carcinoma (PTC) in subacute thyroiditis?
What is the role of amiodarone in the etiology of subacute thyroiditis?
What is the role of lithium in the etiology of subacute thyroiditis?
What causes subacute thyroiditis?
What causes subacute granulomatous thyroiditis?
What is the role of human leukocyte antigen (HLA-B35) in the etiology subacute thyroiditis?
What is the role of growth factors in the etiology of subacute thyroiditis?
What causes subacute lymphocytic thyroiditis?
What is the role of interferon alfa in the etiology of subacute thyroiditis?
What is the role of interleukin 2 in the etiology of subacute thyroiditis?
What causes subacute postpartum thyroiditis?
Which conditions are associated with subacute thyroiditis?
What is the prevalence of subacute thyroiditis?
What are the sexual predilections of subacute thyroiditis?
Which age groups have the highest prevalence of subacute thyroiditis?
What is the prognosis of subacute thyroiditis?
What is the prognosis of thyrotoxicosis from subacute thyroiditis?
What is the prognosis of subacute granulomatous thyroiditis?
What are the acute complications of subacute thyroiditis?
What are the long-term complications of subacute thyroiditis?
What is the prognosis of subacute lymphocytic thyroiditis?
What is the prognosis of subacute postpartum thyroiditis?
Presentation
Which clinical history findings are characteristic of subacute thyroiditis?
What are the phases of subacute granulomatous thyroiditis?
How is subacute granulomatous thyroiditis diagnosed?
What are the signs and symptoms of subacute granulomatous thyroiditis?
What uncommon signs and symptoms of subacute granulomatous thyroiditis?
Which clinical history findings are characteristic of subacute lymphocytic thyroiditis?
Which clinical history findings are characteristic of subacute postpartum thyroiditis?
Which physical findings are characteristic of subacute thyroiditis?
Which physical findings are characteristic of subacute granulomatous thyroiditis?
Which physical findings are characteristic of subacute lymphocytic thyroiditis?
Which physical findings are characteristic of subacute postpartum thyroiditis?
DDX
Which conditions should be considered in the differential diagnosis of subacute thyroiditis?
What are the differential diagnoses for Subacute Thyroiditis?
Workup
What is the role of lab testing in the diagnosis of subacute thyroiditis?
What is the role of serum thyroglobulin measurement in the workup of subacute thyroiditis?
What is the role of the erythrocyte sedimentation rate in the workup of subacute thyroiditis?
What is the role of thyroid autoantibody testing in the workup of subacute thyroiditis?
Which research-oriented tests are not beneficial in the diagnosis of subacute thyroiditis?
What is the role of liver function tests in the diagnosis of subacute thyroiditis?
What is the role of IL-6 testing in the diagnosis of subacute thyroiditis?
What is the role of lab testing in the diagnosis of subacute granulomatous thyroiditis?
What is the role of lab testing in the diagnosis of subacute lymphocytic thyroiditis?
What is the role of lab testing in the diagnosis of subacute postpartum thyroiditis?
What is the role of CT scanning in the diagnosis of subacute thyroiditis?
What is the role of MRI in the diagnosis of subacute thyroiditis?
What is the role of radioiodine uptake in the workup of subacute thyroiditis?
What is the role of ultrasonography in the workup of subacute thyroiditis?
What is the role of sonoelastography in the workup of subacute thyroiditis?
What is the role of fine-needle aspiration (FNA) biopsy in the workup of subacute thyroiditis?
Which histologic findings are characteristic of subacute thyroiditis?
Which histologic findings are characteristic of subacute granulomatous thyroiditis?
Treatment
How is subacute thyroiditis treated?
When is inpatient care indicated for the treatment of subacute thyroiditis?
Which dietary modifications are used in the treatment of subacute thyroiditis?
What activities are restricted in patients with subacute thyroiditis?
Which specialist consultations are beneficial to patients with subacute thyroiditis?
How is subacute thyroiditis prevented?
How is subacute granulomatous thyroiditis treated?
How is hypothyroidism treated in subacute thyroiditis?
What is the role of ipodate in the treatment of subacute thyroiditis?
What is the role of propranolol in the treatment of subacute thyroiditis?
What is included in the long-term monitoring of patients with subacute thyroiditis?
What is included in the long-term monitoring of patients with subacute granulomatous thyroiditis?
Medications
Which medications are used in the treatment of subacute thyroiditis?
Which medications in the drug class Salicylates are used in the treatment of Subacute Thyroiditis?
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Three multinucleated, giant cell granulomas observed in a fine-needle aspiration biopsy of the thyroid; from a patient with thyrotoxicosis resulting from subacute granulomatous thyroiditis.
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Absence of iodine-123 (123I) radioactive iodine uptake in a patient with thyrotoxicosis and lymphocytic (subacute painless) thyroiditis. Laboratory studies at the time of the scan demonstrated the following: thyroid-stimulating hormone (TSH), less than 0.06 mIU/mL; total thyroxine (T4), 21.2 mcg/dL (reference range, 4.5-11); total triiodothyronine (T3), 213 ng/dL (reference range, 90-180); T3-to-T4 ratio, 10; and erythrocyte sedimentation rate (ESR), 10 mm/h. The absence of thyroid uptake, the low T3-to-T4 ratio, and the low ESR confirm the diagnosis of lymphocytic thyroiditis.
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Example of laboratory values as they vary over the course of subacute granulomatous thyroiditis. The entire episode may evolve through all 3 phases of the disorder over a period of as long as 6 months.
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Ultrasonogram of subacute granulomatous thyroiditis. A. Transverse image. B. Sagittal image with Doppler analysis. The echotexture is very heterogeneous and hypoechoic. The vascular flow is absent in much of the affected hypoechoic regions of the lobe and much less than would be expected if this were Graves disease hyperthyroidism.