Subacute (De Quervain's) Thyroiditis

Question 1

When does this commonly occur?

Answer 1

• following viral infection

Question 2

How does this thyroiditis typically present?

Answer 2

hyperthyroidism

Question 3

Describe the 4 typical “phases” in this thyroiditis

Answer 3

Phase 1 (3-6 weeks):
- hyperthyroidism
- painful goitre
- raised ESR

Phase 2 (1-3 weeks):
- euthyroid

Phase 3 (weeks - months):
- hypothyroidism

Phase 4: back to normal

Question 4

What investigation is used to look for this thyroiditis and what does it show?

Answer 4

thyroid scintigraphy
- globally reduced uptake of iodine-131

Question 5

Management

Answer 5

self-limiting - no treatment

Thyroid pain = aspirin/NSAIDs

steroids if hypothyroidism develops/severe symptoms