The contribution of ultrasonographic findings to the prognosis of subacute thyroiditis

Sencar, Muhammed Erkam; Çalapkulu, Murat; Sakız, Davut; Akhanli, Pınar; Hepşen, Sema; Duger, Hakan; Ünsal, İlknur Öztürk; Kızılgül, Muhammed; Çakal, Erman

doi:10.20945/2359-3997000000253

Cited by 11 publications

(14 citation statements)

References 17 publications

(19 reference statements)

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“…Additionally, patchy SAT can be mistaken for multifocal malignancy due to the irregular hypoechoic nature of the parenchymal changes. [32][33][34][35] The most common treatment in COVID-19-induced SAT included short-term corticosteroids, β-adrenoceptor blockers as well as analgesics. [16][17][18] In one case combination treatment of hydroxychloroquine and steroids was reported, 20 although hydroxychloroquine is not currently a recommended therapy.…”

Section: Ta B L E 2 (Continued)mentioning

confidence: 99%

COVID‐19‐related thyroiditis: A novel disease entity?

Dworakowska

Morley

Mulholland

et al. 2021

Clinical Endocrinology

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The literature on COVID‐19‐related thyroid complications has accumulated over the past year or so as the pandemic has accelerated throughout the world. In particular, several recent case reports have been published describing a possible correlation between COVID‐19 disease and subacute thyroiditis (SAT). In this review, we briefly present one of our own patients and review the current published literature in this area up to January 2021, including analyses of major series of thyroid function tests in patients with significant COVID‐19 infection. We conclude that while the great majority of patients with severe COVID‐19 infection may show manifestations of the sick euthyroid syndrome, clinicians should be aware of the possibility of SAT, especially in the early weeks and months following even mild COVID‐19 infection.

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Section: Ta B L E 2 (Continued)mentioning

confidence: 99%

COVID‐19‐related thyroiditis: A novel disease entity?

Dworakowska

Morley

Mulholland

et al. 2021

Clinical Endocrinology

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“…Laboratory findings usually include high C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR), suppressed thyroid-stimulating hormone (TSH), and elevated free thyroxin (fT4) levels. Characteristic ultrasound features of SAT include ill-defined heterogeneous, hypoechoic areas and a lack of flow color Doppler in those areas, and in some patients, diffuse enlargement in the thyroid gland may be seen [9, 10]. These symptoms and laboratory findings are characteristic for the initial (thyrotoxic) phase of SAT.…”

Section: Introductionmentioning

confidence: 99%

Two Important Issues in Subacute Thyroiditis Management: Delayed Diagnosis and Inappropriate Use of Antibiotics

et al. 2021

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Background: Subacute thyroiditis (SAT) is a rare inflammatory disease of the thyroid gland. It has been noticed that patients with a diagnosis of SAT visit more other clinics and receive antibiotics unnecessarily. Therefore, the aim of this study was to reveal the degree of delay in the diagnosis of SAT, prediagnosis antibiotic use rates, and the awareness of clinics for the diagnosis of SAT. Methods: A total of 121 patients with SAT were enrolled in the study. A retrospective analysis was made of the history of patient symptoms during the diagnosis, which physicians they visited, antibiotic use, laboratory test results, and ultrasonographic findings. Results: The median age of the patients was 41 years. Neck pain radiating to the jaw/ear was seen in most patients (71.1%). The median time from symptom onset to a diagnosis of SAT was 23 days (range, 6–70 days). Antibiotics were erroneously prescribed to 71 patients (58.7%) before the diagnosis. The median time to diagnosis was 28 days in patients using antibiotics and 20 days in the group not using antibiotics (p < 0.001). Two or more physicians had been visited before SAT diagnosis by 89 (73.6%) patients, and more antibiotics were prescribed to these patients than the group who visited fewer physicians (p < 0.05). The frequency of prescribing antibiotics by physicians was 73.7% by emergency physicians, 53.1% by family doctors, 51.1% by ENT specialists, and 35.4% by internal medicine specialists. Conclusion: The diagnosis of SAT is often delayed, and misdiagnosis leads to erroneous antibiotic overuse. Physicians should increase their awareness of the diagnosis of SAT in patients with neck pain.

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“…Tables 1 , 2 provide the characteristics, quality and main risk factors for all studies included in the review. The included studies were published between 1985 and 2021 among ten countries: Japan (n = 5) ( 17 , 18 , 22 , 30 , 31 ), Turkey (n = 4) ( 14 , 24 , 25 , 28 ), Poland (n = 2) ( 12 , 26 ), China (n = 1) ( 21 ), Denmark (n = 1) ( 16 ), Italy (n = 1) ( 32 ), Israel (n = 1) ( 27 ), the Kingdom of Saudi Arabia (n = 1) ( 15 ), Thailand (n = 1) ( 11 ), and the USA (n = 1) ( 29 ). The sample size of the included studies varied from 23 ( 15 , 16 ) to 3,344 ( 18 ), and the duration of mean follow-up varied from 2 months ( 22 ) to 5 years ( 28 ).…”

Section: Resultsmentioning

confidence: 99%

“…Five studies reported the age difference for recurrence ( 17 , 18 , 25 , 28 , 31 ). The pooled finding suggested that there was no significant difference in age between the recurrence group (RG) and the non-recurrence group (NRG) (Age MD = -0.46, 95% CI: -2.55, 1.63; Figure 2B ).…”

Section: Resultsmentioning

confidence: 99%

“…Seven studies referred to the recurrence and non-recurrence situation of males and females, and the number of recurrence of males was less than that of females ( 12 , 17 , 24 , 25 , 28 , 30 , 31 ). However, the pooled recurrence rate showed that there was no significant difference in sex between the RG and NRG groups (RR = 0.69, 95% CI: 0.41, 1.15; Figure 2C ).…”

Section: Resultsmentioning

confidence: 99%

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Risk Factors for Subacute Thyroiditis Recurrence: A Systematic Review and Meta-Analysis of Cohort Studies

Zhang

Ding

et al. 2021

Front. Endocrinol.

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BackgroundSubacute thyroiditis (SAT) is a self-limited inflammatory thyroid disease with recurring episodes. However, the results regarding the recurrence rate and risk factors for SAT are inconsistent. This meta-analysis aimed to summarize the evidence of the recurrence rate and the risk factors for SAT.MethodsThe present study involved the performance of a systematic literature search of all English studies published in PubMed, Embase, Web of Science, and The Cochrane Library from inception to August 20, 2021. Cohort studies that reported the SAT recurrence rate and risk factors for recurrence were included. Two independent investigators extracted relevant information. Fixed- and random-effects models were used to pool effect sizes based on study heterogeneity.ResultsEighteen cohort studies were identified. The pooled findings showed that the recurrence rate was 12.0% (95% CI: 8.2%, 17.1%). The risk of recurrence in the glucocorticoids group was higher than that in the NSAIDs group (RR = 1.84, 95% CI: 1.04, 3.24). However, there was no significant difference in age or sex between the recurrence group and the non-recurrence group. Findings from one or two cohort studies also indicated that the copresence of HLA-B*18:01 and -B*35, the number of days required to taper prednisolone (PSL) to 5 mg/day, the duration of disease before treatment less than 30 days, the sialic acid level, or the TSH level at the termination of treatment and further extension of the hypoechoic area and increase in thyroid volume were related to the recurrence of SAT.ConclusionRecurrence was common in SAT patients. The present study indicated that glucocorticoid treatment was associated with a higher recurrence rate of SAT than NSAIDs treatment. The clinical implications of this association should be interpreted with caution, and further clinical trials on the long-term effects of different treatment strategies are needed.

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The contribution of ultrasonographic findings to the prognosis of subacute thyroiditis

Cited by 11 publications

References 17 publications

COVID‐19‐related thyroiditis: A novel disease entity?

COVID‐19‐related thyroiditis: A novel disease entity?

Two Important Issues in Subacute Thyroiditis Management: Delayed Diagnosis and Inappropriate Use of Antibiotics

Risk Factors for Subacute Thyroiditis Recurrence: A Systematic Review and Meta-Analysis of Cohort Studies

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