De Quervain's thyroiditis
Encyclopedia
de Quervain's thyroiditis, can also be known as subacute granulomatous thyroiditis
or Giant Cell Thyroiditis. Males and females of all ages are affected. It is a member of the group of thyroiditis conditions known as resolving thyroiditis.
, but there is another form of subacute thyroiditis, subacute lymphocytic thyroiditis.
It is also sometimes called "painful subacute thyroiditis". This is in contrast to subacute lymphocytic thyroiditis, which is also sometimes called "painless thyroiditis".
in origin, perhaps preceded by an upper respiratory tract infection
. Viral causes include Coxsackie virus, mumps
and adenoviruses. Some cases develop postpartum.
production and the inappropriately released colloid is depleted before resolving to euthyroid. The symptoms are those of hyperthyroidism
and hypothyroidism
. In addition, patients may suffer from painful dysphagia
. There are multi-nucleated giant cells on histology. Thyroid antibodies can be present in some cases. The clinical presentation during the hyperthyroid phase can mimc that of diffuse toxic goiter (Grave's disease). In such cases, a radionuclide thyroid uptake and scan can be helpful, since subacute thyroiditis will result in decreased isotope uptake, while Grave's disease will generally result in increased uptake. Distinguishing between these two diseases is important, since Grave's disease can be treated with radioiodine therapy, but subacute thyroiditis is usually self-limited and is not treated with radioiodine.
. It should not be confused with DeQuervain's syndrome
.
Thyroiditis
Thyroiditis is the inflammation of the thyroid gland. The thyroid gland is located on the front of the neck below the laryngeal prominence, and makes hormones that control metabolism.-Classification:...
or Giant Cell Thyroiditis. Males and females of all ages are affected. It is a member of the group of thyroiditis conditions known as resolving thyroiditis.
Terminology
It is sometimes called subacute thyroiditisSubacute thyroiditis
Subacute thyroiditis is a form of thyroiditis that can be a cause of both thyrotoxicosis and hypothyroidism. It is uncommon and can affect individuals of both sexes and all ages. It manifests as a sudden and painful enlargement of the thyroid gland accompanied with fever, malaise and muscle aches...
, but there is another form of subacute thyroiditis, subacute lymphocytic thyroiditis.
It is also sometimes called "painful subacute thyroiditis". This is in contrast to subacute lymphocytic thyroiditis, which is also sometimes called "painless thyroiditis".
Causes
Some cases may be viralVirus
A virus is a small infectious agent that can replicate only inside the living cells of organisms. Viruses infect all types of organisms, from animals and plants to bacteria and archaea...
in origin, perhaps preceded by an upper respiratory tract infection
Upper respiratory tract infection
Upper respiratory tract infections are the illnesses caused by an acute infection which involves the upper respiratory tract: nose, sinuses, pharynx or larynx...
. Viral causes include Coxsackie virus, mumps
Mumps
Mumps is a viral disease of the human species, caused by the mumps virus. Before the development of vaccination and the introduction of a vaccine, it was a common childhood disease worldwide...
and adenoviruses. Some cases develop postpartum.
Presentation
Patients will experience a hyperthyroid period as the cellular lining of colloid spaces fails, allowing abundant colloid into the circulation, with neck pain and fever. Patients typically then become hypothyroid as the pituitary reduces TSHTSH
TSH may refer to:* Tanzanian shilling, the currency of Tanzania* Thyroid-stimulating hormone, a hormone synthesized and secreted by thyrotrope cells* Tshiuetin Rail Transportation, a Canadian railway between Labrador and Quebec...
production and the inappropriately released colloid is depleted before resolving to euthyroid. The symptoms are those of hyperthyroidism
Hyperthyroidism
Hyperthyroidism is the term for overactive tissue within the thyroid gland causing an overproduction of thyroid hormones . Hyperthyroidism is thus a cause of thyrotoxicosis, the clinical condition of increased thyroid hormones in the blood. Hyperthyroidism and thyrotoxicosis are not synonymous...
and hypothyroidism
Hypothyroidism
Hypothyroidism is a condition in which the thyroid gland does not make enough thyroid hormone.Iodine deficiency is the most common cause of hypothyroidism worldwide but it can be caused by other causes such as several conditions of the thyroid gland or, less commonly, the pituitary gland or...
. In addition, patients may suffer from painful dysphagia
Dysphagia
Dysphagia is the medical term for the symptom of difficulty in swallowing. Although classified under "symptoms and signs" in ICD-10, the term is sometimes used as a condition in its own right. Sufferers are sometimes unaware of their dysphagia....
. There are multi-nucleated giant cells on histology. Thyroid antibodies can be present in some cases. The clinical presentation during the hyperthyroid phase can mimc that of diffuse toxic goiter (Grave's disease). In such cases, a radionuclide thyroid uptake and scan can be helpful, since subacute thyroiditis will result in decreased isotope uptake, while Grave's disease will generally result in increased uptake. Distinguishing between these two diseases is important, since Grave's disease can be treated with radioiodine therapy, but subacute thyroiditis is usually self-limited and is not treated with radioiodine.
Eponym
It is named for Fritz de QuervainFritz de Quervain
Fritz de Quervain was a Swiss surgeon born in Sion. He was a leading authority on thyroid disease.In 1892 he received his doctorate from the University of Bern, and several years later became director of the surgical department at a hospital in La Chaux-de-Fonds in the canton of Neuchâtel...
. It should not be confused with DeQuervain's syndrome
DeQuervain's syndrome
De Quervain syndrome , is a tendinosis of the sheath or tunnel that surrounds two tendons that control movement of the thumb.-Eponym:It is named after the Swiss surgeon Fritz de Quervain who first identified it in 1895...
.