Subacute Thyroiditis: Clinical Presentation and Long Term Outcome

Abstract

Few studies have been reported from the Kingdom of Saudi Arabia (SA) to describe the clinical presentation and long term outcomes of subacute thyroiditis (SAT). Our aim was to review the demographic, anthropometric, clinical presentation, laboratory results, treatment, and disease outcome in Riyadh region and to compare those with results from different regions of the Kingdom and different parts of the world. We reviewed the medical files of patients who underwent thyroid uptake scan during an 8-year period in King Khalid University Hospital. Only 25 patients had confirmed diagnosis of thyroiditis. Age and gender distribution were similar to other studies. Most patients presented with palpitation, goiter, and weight change. Elevated thyroid hormones, suppressed thyroid-stimulating hormone, and elevated ESR were reported. Among those, 7 cases of SAT were recorded. β-Blockers were prescribed to 57% and nonsteroidal anti-inflammatory drugs to 29% of SAT. Long follow-up demonstrated that 85.7% of SAT cases recovered, while 14.3% developed permanent hypothyroidism. In conclusion, SAT is uncommon in the central region of SA. Compared to the western region, corticosteroid is not commonly prescribed, and permanent hypothyroidism is not uncommon. A nation-wide epidemiological study to explain these interprovincial differences is warranted.

Time-Lag Between Symptom Onset and Diagnosis of Subacute Thyroiditis – How to Avoid the Delay of Diagnosis and Unnecessary Overuse of Antibiotics

“…The most common presentation is the anterior neck pain, which characteristically radiates up to the jaw and ear, and down to the sternum [2][3][4]. However, SAT cases occurring without pain are more and more often described [5][6][7].…”

“…mately after 8-16 weeks). Phase 3 with subsequent hypothyroidism does not occur frequently and persistent hypothyroidism is extremely rare [1,3,4].…”

Subacute Thyroiditis—An Often Overlooked Sonographic Diagnosis

“…Patients often have a preceding history of an upper respiratory tract infection with a prodromal phase of low‐grade fever and malaise 1 – 3 . The thyroid gland is tender to palpation, and a small diffuse goiter may be present 4 . Occasionally, subacute thyroiditis can present with a nontender nodule 3 , 5 .…”

“…[1][2][3] The thyroid gland is tender to palpation, and a small diffuse goiter may be present. 4 Occasionally, subacute thyroiditis can present with a nontender nodule. 3,5 The clinical course includes 3 characteristic phases.…”

Thyroid Ultrasound: State of the Art Part 1 – Thyroid Ultrasound reporting and Diffuse Thyroid Diseases

“…Subacute granulomatous thyroiditis (SGT) is a self-limiting subacute inflammatory disease of the thyroid [57]. It typically occurs in the area of the gland in mid-aged hyperthyroid women complaining of pain, tenderness, fatigue and mild fever [58] and constitutes nearly 3-6% of all thyroid diseases. Generally appears 2 weeks after a viral upper respiratory tract infection and regresses spontaneously within 2-3 months.…”