Granulomatous thyroiditis
Granulomatous thyroiditis
Updated: 12/13/2018
© Jun Wang, MD, PhD
General features
- AKA de Quervain's thyroiditis, subacute granulomatous thyroiditis
- Most common cause of thyroid pain
- Painful swallowing (odynophagia), sore throat, thyroid region tenderness, fever, fatigue, malaise
- May be associated with systemic viral infection
- Usually self limited, resolves in 6-8 weeks with transient hypothyroidism
Key laboratory findings
- Early: Elevated T3 and T4, low radioactive iodine uptake
- Late: Hypothyroidism and anti-thyroid antibodies
Pathological features
- Focal to diffuse enlargement of thyroid gland
- Early: neutrophils and destruction of follicles with colloid depletion
- Later: noncaseating granulomas surround follicles and engulf colloid
- Late: fibrosis
Treatment
- Pain management: NSAID or corticosteroid
- Hyperthyroidism management: Beta blockers, etc
- Hypothyroidism management: Hormone replacement, etc
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