Subacute Thyroiditis—Still a Diagnostic Challenge: Data from an Observational Study

Taiba Zornitzki, Sorcha Mildiner, Tal Schiller, Alena Kirzhner, Viviana Ostrovsky and Hilla Knobler
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Taiba Zornitzki: Diabetes, Endocrinology and Metabolic Disease Institute, Kaplan Medical Center, The Faculty of Medicine, Hebrew University of Jerusalem, Rehovot 9190401, Israel
Sorcha Mildiner: Internal Medicine Department, Kaplan Medical Center, Rehovot 9190401, Israel
Tal Schiller: Diabetes, Endocrinology and Metabolic Disease Institute, Kaplan Medical Center, The Faculty of Medicine, Hebrew University of Jerusalem, Rehovot 9190401, Israel
Alena Kirzhner: Diabetes, Endocrinology and Metabolic Disease Institute, Kaplan Medical Center, The Faculty of Medicine, Hebrew University of Jerusalem, Rehovot 9190401, Israel
Viviana Ostrovsky: Diabetes, Endocrinology and Metabolic Disease Institute, Kaplan Medical Center, The Faculty of Medicine, Hebrew University of Jerusalem, Rehovot 9190401, Israel
Hilla Knobler: Diabetes, Endocrinology and Metabolic Disease Institute, Kaplan Medical Center, The Faculty of Medicine, Hebrew University of Jerusalem, Rehovot 9190401, Israel

IJERPH, 2022, vol. 19, issue 15, 1-8

Abstract: Background: Subacute thyroiditis (SAT) is a relatively common cause of thyroid disease. However, only a few studies evaluating SAT have been published in recent years with varying diagnostic criteria. We evaluate the clinical presentation and long-term outcome of isotope scan-confirmed SAT. Methods: A retrospective study of 38 patients with isotope scan-confirmed SAT was performed at a single isotope department. All patients were contacted for long-term follow-up. Results: The female/male ratio was 1.4:1, and mean age was 47 ± 14 years and 62 ± 12 years in women and men, respectively ( p = 0.002). Almost half of the cases (42%) occurred during the summer. The most common symptoms were neck pain (74%) and weakness (61%). Palpitations, weight loss, heat intolerance, and sweating appeared in 50%, 42%, 21%, and 21%, respectively. Only half of the patients reported fever. TSH level was low in all patients, and mean FT4 and FT3 level were about twice the upper limit of normal range. Elevated CRP and ESR occurred in the majority (88%) of patients. The mean time period between the first clinic visit and performing thyroid function tests was 8 ± 7 days. One-third of the patients initially received a diagnosis of upper respiratory tract infection (URI). NSAIDs and steroids were prescribed to 47% and 8% of patients, respectively. Long-term follow-up of 33.5 months (range 9–52) revealed that 25% remained with subclinical or overt hypothyroidism. Conclusions: These data demonstrate that although SAT is a common entity, there is still a significant delay in diagnosis, and in a third of our patients, the initial diagnosis was URI, with 25% developing long-term hypothyroidism.

Keywords: subacute; thyroiditis; thyroid scan; quality of care (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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