What is subacute granulomatous thyroiditis?

Updated: Mar 23, 2021
  • Author: Stephanie L Lee, MD, PhD; Chief Editor: Romesh Khardori, MD, PhD, FACP  more...
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Answer

Subacute granulomatous thyroiditis is the most common cause of a painful thyroid gland. This condition is also known as painful subacute thyroiditis, de Quervain thyroiditis, and migratory thyroiditis (this last because the pain can shift to different locations in the thyroid). It is a transient inflammation of the thyroid, the clinical course of which is highly variable. Most patients have pain in the region of the thyroid, which is usually diffusely tender, and some have systemic symptoms. Thyrotoxicosis often occurs initially, sometimes followed by transient hypothyroidism. Complete recovery in weeks to months is characteristic. Some patients will clinically note only one phase—thyrotoxic or hypothyroid—while others will note both. (See the Table, below.)

Table. Characteristic Course of Subacute Granulomatous Thyroiditis (Open Table in a new window)

Parameters

Stage 1

Stage 2

Stage 3

Stage 4

Symptoms

Thyrotoxicosis

Euthyroid

Hypothyroid

Euthyroid (recovery)

T4, T3

Elevated

Normal

Decreased

Normal

TSH

Decreased

Normal

Elevated

Normal

T4 = thyroxine

T3 = triiodothyronine

TSH = thyroid-stimulating hormone


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