Tuesday, 26 October 2010

MRCP revision battle 35.2: Subacute (de Quervain's) thyroiditis

Subacute (de Quervain's) thyroiditis is the label given to a viral infection which causes a painful goitre and potentially transient hyper or hypo thyroidism.

In addition to a painful goitre the patient may have a fever and dysphagia.

Classically it occurs following a upper respiratory tract infection but it may occur after any viral illness (mumps, adenovirus) and also post-partum.

Histology would show multi-nucleated giant cells.
Radioiodine uptake is typically less than 1% at 24 hrs.

Treatment is with NSAIDs.  It resolves spontaneously.

Onwards to Hashimotos...