De Quervain's thyroiditis

GS undefined

de Quervain's thyroiditis, is also known as subacute granulomatous thyroiditis or subacute thyroiditis; usually occurs in women between 30 and 50 years of age. It is a member of the group of thyroiditis conditions known as resolving thyroiditis.

Causes
Some cases may be viral in origin, perhaps preceded by an upper respiratory tract infection. Some cases develop postpartum.

Presentation
Patients will experience a hyperthyroid period as the cellular lining of colloid spaces fails, allowing abundant colloid into the circulation, with neck pain and fever. Patients typically then become hypothyroid as the pituitary reduces TSH production and the inappropriately released colloid is depleted before resolving to euthyroid. The symptoms are those of hyperthyroidism and hypothyroidism. In addition, patients may suffer from painful dysphagia. There are multi-nucleated giant cells on histology.

Treatment
Treatment is NSAID.

Corticosteroids may be of help in refractory cases.

Eponym
It is named for Fritz de Quervain. It should not be confused with DeQuervain's syndrome.