Summary about Disease
Subacute thyroiditis is an inflammatory disorder of the thyroid gland, typically causing neck pain and tenderness along with symptoms of hyperthyroidism (overactive thyroid), followed by hypothyroidism (underactive thyroid) before usually recovering to normal thyroid function. It's often preceded by a viral upper respiratory infection. It's also known as De Quervain's thyroiditis, granulomatous thyroiditis, or giant cell thyroiditis.
Symptoms
Pain in the neck, often radiating to the jaw, ear, or chest
Tenderness to the touch over the thyroid gland
Difficulty swallowing
Hoarseness
Fatigue
Hyperthyroidism symptoms (initially): anxiety, irritability, rapid heartbeat, heat intolerance, sweating, weight loss, tremors
Hypothyroidism symptoms (later): fatigue, weight gain, constipation, dry skin, cold intolerance, depression
Causes
The exact cause is unknown, but subacute thyroiditis is often associated with a preceding viral infection of the upper respiratory tract. Potential viruses implicated include:
Coxsackievirus
Mumps virus
Measles virus
Adenovirus
Echovirus
Medicine Used
Pain Relief: Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen are often the first line of treatment for pain and inflammation. In more severe cases, corticosteroids like prednisone may be prescribed.
Hyperthyroidism Symptoms: Beta-blockers (e.g., propranolol, atenolol) can help manage symptoms like rapid heart rate, tremors, and anxiety during the hyperthyroid phase.
Hypothyroidism Symptoms: Levothyroxine (synthetic thyroid hormone) may be prescribed if hypothyroidism is significant or prolonged.
Is Communicable
Subacute thyroiditis itself is not communicable. However, if it is triggered by a viral infection, that initial viral infection might be communicable.
Precautions
Since the exact cause isn't fully understood, specific precautions are limited. General measures to prevent viral infections, such as frequent handwashing and avoiding close contact with sick individuals, may be helpful. There is no specific precaution to avoid getting Subacute Thyroiditis beyond general health and hygeine
How long does an outbreak last?
The course of subacute thyroiditis is typically self-limiting, lasting weeks to months (2-6 months). It often progresses through three phases:
Hyperthyroid phase: 1-3 months
Hypothyroid phase: Weeks to months.
Recovery phase: Thyroid function usually returns to normal within a few months. In some cases, hypothyroidism can be permanent.
How is it diagnosed?
Diagnosis typically involves:
Physical Examination: Assessing the thyroid gland for tenderness and enlargement.
Blood Tests:
Thyroid hormone levels (T4, T3) and TSH (thyroid-stimulating hormone) to assess thyroid function (initially high T4 and T3, suppressed TSH, then potentially low T4 and T3, elevated TSH).
Erythrocyte Sedimentation Rate (ESR) and C-reactive protein (CRP) are usually elevated, indicating inflammation.
Thyroid antibodies are usually negative.
Thyroid Scan with Radioactive Iodine Uptake: Shows low uptake of iodine by the thyroid gland.
Fine Needle Aspiration Biopsy: Rarely needed, but may be considered if the diagnosis is uncertain or if there is concern for other thyroid conditions.
Timeline of Symptoms
1. Viral Prodrome (Optional): Some patients experience a viral upper respiratory infection in the weeks preceding the onset of thyroid symptoms. 2. Pain and Inflammation: Neck pain and tenderness develop gradually or suddenly. 3. Hyperthyroid Phase: Symptoms of hyperthyroidism emerge as thyroid hormone is released from the damaged thyroid cells (weeks to months). 4. Hypothyroid Phase: As the thyroid hormone stores are depleted, symptoms of hypothyroidism develop (weeks to months). 5. Recovery Phase: Thyroid function gradually returns to normal (months). Some patients may have residual hypothyroidism.
Important Considerations
Differentiation from other conditions: It's crucial to differentiate subacute thyroiditis from other thyroid disorders like Graves' disease or Hashimoto's thyroiditis, which require different management.
Recurrence: Although uncommon, subacute thyroiditis can recur.
Permanent Hypothyroidism: A small percentage of individuals may develop permanent hypothyroidism and require lifelong thyroid hormone replacement therapy.
Monitoring: Regular monitoring of thyroid function is important throughout the course of the disease and after recovery to detect any long-term complications.
Pregnancy: Special consideration is needed for pregnant women, as thyroid dysfunction can affect both mother and fetus.