This condition is also known as painful subacute thyroiditis, de Quervain thyroiditis, and migratory thyroiditis (this last because the pain can shift. Subacute disease includes granulomatous or De Quervain's thyroiditis and lymphocytic thyroiditis or silent thyroiditis. The chronic group. Prevalence: subacute granulomatous de Quervain's thyroiditis (DQ) is a rare disorder among thyroid diseases. In our practice the ratio of DQ to Hashimoto's.
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Diagnosis[ edit ] In the initial phase of damage to the gland, preformed thyroid hormone will 'fall out' of the damaged cells.
Granulation around surgical thread and tiroiditis de quervain thyroiditis may occur. The history of the patient decides the question in the former case, such granulation occurring in patients who have previously undergone thyroid or neck surgery.
These patients present no fever, the ESR is not elevated, and pain, if tiroiditis de quervain, is localized to the small, hard lesion, without radiating toward the neck or ear. Moreover, in these smears debris of surgical thread may be seen, a phenomenon which does not arise in cases of de Quervain's thyroiditis.
De Quervain thyroiditis | Radiology Reference Article |
In rare instances, lymphocytic thyroiditis may produce a similar clinical and also a cytological picture with multinucleated giant cells.
On the other tiroiditis de quervain, epitheloid cells are rarely present in chronic thyroiditis. If multinucleated giant cells tiroiditis de quervain not present in the smear a definitive cytological diagnosis is not possible. If we are aware of the history of the patient, a combined clinical-cytological diagnosis in cases with a typical clinical presentation of de Quervain's thyroiditis encounters no problem.
The only differential diagnostic problem occurs in cases without a clear-cut clinical presentation and without multinucleated giant cells in the smear.
Two other possibilities must be considered. The first is anaplastic carcinoma of tiroiditis de quervain thyroid with a concomitant inflammatory reaction.
This is a very rare possibility, but in patients aged over 60 years tiroiditis de quervain must be considered. If the cytology is not decisive, it must be repeated, because no other tool is able to differentiate between the two types of lesion.
The clinical picture may also be of help: Most of the differential diagnostic problems arise in to the other situation: Most of these problematic cases are tiroiditis de quervain to the latter type.
Thyroiditis: definitions, causes, and treatments. - Inflammation of the Thyroid Gland
If the level of thyroid autoantibodies is elevated, this decides the question. On the other hand, no other decisive signs specific for either disease tiroiditis de quervain available.
- Subacute, granulomatous de Quervain's thyroiditis
- De Quervain's Thyroiditis
- What Is Thyroiditis?
- De Quervain's thyroiditis
If tests tiroiditis de quervain autoantibodies are negative, the follow-up of the patients may be of help. In our practice, besides tiroiditis de quervain de Quervain's thyroiditis and subacute silent lymphocytic thyroiditis cases, there were 60 cases where we could not decide on the type of the underlying disease at the first examination.
On follow-up examinations, complete normalization of the US pattern favours the diagnosis of previous de Quervain's thyroiditis this occurred in 9 of 60 caseswhile persistent hypothyroidism is seen only in cases of lymphocytic thyroiditis 31 of 60 cases.
Steroid therapy, which has a dramatic benefit on patients with de Quervain's thyroiditis, had no effect in these cases. Treatment is usually tiroiditis de quervain rest and aspirin to reduce inflammation.
De Quervain's thyroiditis - Wikipedia
Occasionally cortisone steroids, which reduce inflammation and thyroid hormone to "rest" the thyroid gland may be used in prolonged cases. Nearly all patients recover, and the thyroid gland returns to tiroiditis de quervain after several weeks or months. A few patients will become hypothyroid once the inflammation settles down and therefore will need to stay on thyroid hormone replacement indefinitely.
Silent Thyroiditis Silent thyroiditis is the third and least common type of thyroiditis. Inflammatory diseases, are the most common thyroid disorders encountered in clinical practice.
Some of these present to the otolaryngologists, as painful deglutition or odynophagia, which tiroiditis de quervain be a very distressing symptom.