Int J Thyroidol.  2016 Nov;9(2):145-151. 10.11106/ijt.2016.9.2.145.

Subacute Thyroiditis and Painless Thyroiditis: Clinical Characteristics of 221 Patients Diagnosed between 2009 and 2015

Affiliations
  • 1Department of Internal Medicine, Bundang Jesaeng Hospital, Seongnam, Korea. yhk@dmc.or.kr

Abstract

BACKGROUND AND OBJECTIVES
In the past, subacute thyroiditis causing thyrotoxicosis included both painful and painless subgroup, but it is representative for the painful subacute thyroiditis these days. So we evaluated the clinical and laboratory characteristics of subacute thyroiditis and compared with the painless (silent) thyroiditis, and identified predictive factors of permanent hypothyroidism and recurrence.
MATERIALS AND METHODS
This was a retrospective case series study analyzing clinical data of 221 consecutive patients diagnosed between 2009 and 2015. Medical records were reviewed for diagnostic route, age distribution, laboratory data, clinical course and long-term follow up outcome.
RESULTS
The mean age was 48 years; female v/s male ratio 3.4:1. Median disease duration was 110 days; mean peak free T4 level was 2.9 ng/dL. 56.7% of painless thyroiditis patients were diagnosed on health checkup or routine thyroid function test with symptoms not typically associated with thyrotoxicosis. Permanent hypothyroidism was not uncommon (11/221; 5.0%). Higher peak thyroid-stimulating hormone (TSH) was associated with permanent hypothyroidism in painless thyroiditis. Lower peak TSH was associated with recurrence rate in both subacute and painless thyroiditis. In painless thyroiditis, short duration of thyrotoxicosis phase was also associated with recurrence rate.
CONCLUSION
Considerable numbers of painless thyroiditis without symptoms were diagnosed on health checkup. Higher peak TSH was associated with permanent hypothyroidism in painless thyroiditis. Recurrence rate was related with lower peak TSH in both groups.

Keyword

Subacute thyroiditis; Painless thyroiditis; Postpartum thyroiditis; Permanent hypothyroidism; Recurrence

MeSH Terms

Age Distribution
Female
Follow-Up Studies
Humans
Hypothyroidism
Male
Medical Records
Postpartum Thyroiditis
Recurrence
Retrospective Studies
Thyroid Function Tests
Thyroid Gland*
Thyroiditis*
Thyroiditis, Subacute*
Thyrotoxicosis
Thyrotropin
Thyrotropin

Figure

  • Fig. 1. Age distribution of subacute and painless thyroiditis, including postpartum painless thyroiditis patients (postpartum thyroiditis is not included in painless thyroiditis in this figure).


Reference

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