Subacute thyroiditis presenting as a painful suspicious thyroid nodule

Zeng, Wanling; Tan, Sophie Seine Xuan; King, Thomas H.

doi:10.1530/edm-21-0135

Cited by 4 publications

(1 citation statement)

References 9 publications

(16 reference statements)

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“…Thus, the clinicians are obliged to be aware of this matter that SAT might present as suspicious nodular lesions on ultrasound and may require thyroid FNA, which is rarely used in diagnostic workups. However, one study suggested that margin, vascularity, and echogenicity may help differentiate the characteristics of SAT and malignancy and thus, the requirement for FNA gets reduced ( 75 ). Fifteen of the patients we reviewed underwent an FNA to confirm the diagnosis.…”

Section: Discussionmentioning

confidence: 99%

Subacute thyroiditis following COVID-19: A systematic review

et al. 2023

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BackgroundSubacute thyroiditis (SAT) is a self-limiting thyroid inflammatory disease occurring specifically after upper respiratory tract infections. Since COVID-19 is a respiratory disease leading to multi-organ involvements, we aimed to systematically review the literature regarding SAT secondary to COVID-19.MethodsWe searched Scopus, PubMed/MEDLINE, Cochrane, Web of Science, ProQuest, and LitCovid databases using the terms “subacute thyroiditis” and “COVID-19” and their synonyms from inception to November 3, 2022. We included the original articles of the patients with SAT secondary to COVID-19. Studies reporting SAT secondary to COVID-19 vaccination or SAT symptoms’ manifestation before the COVID-19 infection were not included.ResultsTotally, 820 articles were retained. Having removed the duplicates, 250 articles remained, out of which 43 articles (40 case reports and three case series) with a total of 100 patients, were eventually selected. The patients aged 18–85 years (Mean: 42.70, SD: 11.85) and 68 (68%) were women. The time from the onset of COVID-19 to the onset of SAT symptoms varied from zero to 168 days (Mean: 28.31, SD: 36.92). The most common symptoms of SAT were neck pain in 69 patients (69%), fever in 54 (54%), fatigue and weakness in 34 (34%), and persistent palpitations in 31 (31%). The most common ultrasonographic findings were hypoechoic regions in 73 (79%), enlarged thyroid in 46 (50%), and changes in thyroid vascularity in 14 (15%). Thirty-one patients (31%) were hospitalized, and 68 (68%) were treated as outpatients. Corticosteroids were the preferred treatment in both the inpatient and outpatient settings (25 inpatients (81%) and 44 outpatients (65%)). Other preferred treatments were nonsteroidal anti-inflammatory drugs (nine inpatients (29%) and 17 outpatients (25%)) and beta-blockers (four inpatients (13%) and seven outpatients (10%)). After a mean duration of 61.59 days (SD: 67.07), 21 patients (23%) developed hypothyroidism and thus, levothyroxine-based treatment was used in six of these patients and the rest of these patients did not receive levothyroxine.ConclusionSAT secondary to COVID-19 seems to manifest almost similarly to the conventional SAT. However, except for the case reports and case series, lack of studies has limited the quality of the data at hand.

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Section: Discussionmentioning

confidence: 99%

Subacute thyroiditis following COVID-19: A systematic review

et al. 2023

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The diagnostic value of ultrasound on different-sized thyroid nodules based on ACR TI-RADS

Li,

Chen,

et al. 2023

Endocrine

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Diagnostic value of American College of Radiology Thyroid Imaging Reporting and Data System combined with elastography in differentiating clinically atypical subacute thyroiditis from papillary thyroid carcinoma: a single retrospective research

Chen,

Hu,

Sun

et al. 2023

Egypt J Radiol Nucl Med

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Background Common ultrasound imaging is hard to distinguish thyroid nodules of clinically atypical subacute thyroiditis (CAST) with papillary thyroid carcinoma (PTC). The purpose of this study was to investigate the diagnostic value of real-time elastography combined with American College of Radiology Thyroid Imaging Reporting and Data System (ACR-TIRADS) in differentiating these two lesions. Results Centripetal reduction echogenicity was only observed in the CAST nodules, with high specificity (100%) though low sensitivity (23.96%). Echogenic foci yielded good capability for differentiating PTC and CAST, with odds ratio (OR) of 36.572 and AUC of 0.788. Size and ES were independent factors to distinguish the two lesions with OR of 10.709 and 3.697, respectively. The combination of microcalcification, size < 10 mm and ES of 4 showed better AUC (0.885) than echogenic foci alone (p < 0.001). TI-RADS showed high sensitivity (91.23%) with specificity of 30.21% and AUC of 0.607 in predicting malignancy risk of PTC from CAST, while the AUC of ES and the combination of both methods were 0.508 and 0.585, respectively. Conclusions Centripetal reduction echogenicity, echogenic foci, size and ES may assist in the differential diagnosis of CAST and PTC nodules. ACR TI-RADS is superior to ES and the combination of both methods for distinguishing these two lesions.

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Subacute thyroiditis presenting as a painful suspicious thyroid nodule

Cited by 4 publications

References 9 publications

Subacute thyroiditis following COVID-19: A systematic review

Subacute thyroiditis following COVID-19: A systematic review

The diagnostic value of ultrasound on different-sized thyroid nodules based on ACR TI-RADS

Diagnostic value of American College of Radiology Thyroid Imaging Reporting and Data System combined with elastography in differentiating clinically atypical subacute thyroiditis from papillary thyroid carcinoma: a single retrospective research

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