Subacute granulomatous thyroiditis

De Quervain thyroiditis, or subacute granulomatous thyroiditis, is a form of self-limited subacute thyroiditis usually preceded by an upper respiratory tract viral infection such as mumps, measles, coxsackie virus, adenovirus, and influenza viruses.

Epidemiology

It usually affects middle-age females.

Clinical presentation

Most patients present with a painful neck along with symptoms and signs of thyrotoxicosis including tachycardia, hot flushes, heat intolerance and palpitations. Subsequently, a short period of hypothyroidism ensues, followed, in the majority of cases, by a return of a euthyroid state.

Radiographic features

Ultrasound

The most commonly described sonographic appearance is poorly defined regions of decreased echogenicity with decreased vascularity in the affected areas . These can be bilateral or unilateral. The thyroid gland size is mostly normal but can occasionally be enlarged or smaller in size .

Nuclear medicine 

Low uptake thyroid scan in patients with hyperthyroidism is almost diagnostic, in appropriate clinical setting and ultrasound findings. Correct diagnosis is important as treatment with radioiodine is contraindicated in these patients - it is a self-limiting disease.

Treatment and prognosis

It is usually self-limiting.

History and etymology

Named after Fritz de Quervain (1868-1940), a Swiss surgeon.

See also

• thyroid inflammatory conditions

Siehe auch:

• Thyreoiditis