Diagnosis and Management of Thyroiditis

Hendrick, James W.

doi:10.1001/jama.1957.02980020007002

Cited by 26 publications

(6 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…It is widely quoted in the literature that the incidence of AST lies between 0.1%‐0.7% of all thyroid disease 4 ; however this is largely derived from retrospective studies of surgical specimens, 17,18 its true incidence is likely to be much lower. It can occur at any age with the median age in our study of 40 years for bacterial AST, similar to previous studies 1‐3 .…”

Section: Discussionmentioning

confidence: 99%

Suppurative thyroiditis: Systematic review and clinical guidance

Lafontaine

Learoyd

Farrel

et al. 2021

Clinical Endocrinology

View full text Add to dashboard Cite

Acute suppurative thyroiditis (AST) is a rare condition. The following factors are thought to make the thyroid relatively resistant to infection: the thyroid capsule, its rich blood supply and lymph drainage and its high iodine concentration. 1 The usual presentation of AST is with neck pain, fever, elevated white cell count (WCC), elevated ESR and at times hyperthyroidism, making it initially difficult to clinically distinguish from subacute thyroiditis (SAT), although patients with AST are often systemically unwell while those with SAT less so. SAT (also known as de Quervain's or granulomatous thyroiditis) is a much more common, self-limiting condition that may require treatment with anti-inflammatory drugs or glucocorticoids.Acute suppurative thyroiditis has a reported mortality of 3.7%-9% 2,3 and therefore it is crucial to make a timely diagnosis. Due to its low incidence, our knowledge of AST is based on isolated case reports, small case series, two reviews over the past 90 years (describing the literature from 1900-1980 by Berger et al and 1980-1997 by Yu et al) 2,3 and one expert opinion guideline. 4 The purpose of this paper is to report 2 unpublished cases, and to perform a systematic review of reported cases over the past 20 years of the epidemiology, clinical features, investigations, management

show abstract

Section: Discussionmentioning

confidence: 99%

Suppurative thyroiditis: Systematic review and clinical guidance

Lafontaine

Learoyd

Farrel

et al. 2021

Clinical Endocrinology

View full text Add to dashboard Cite

show abstract

“…Patients with AST typically present with acute onset fever and painful neck swelling with or without compressive symptoms such as dysphagia and hoarseness, and some cases are preceded by an upper respiratory illness. 1 , 2 , 22 Laboratory findings in AST can include leukocytosis, elevated inflammatory markers, and elevated thyroglobulin, though the utility of measuring thyroglobulin and inflammatory markers has been questioned. 3 , 9 The majority of patients with AST are euthyroid, though both thyrotoxicosis and hypothyroidism have been reported.…”

Section: Discussionmentioning

confidence: 99%

Thyrotoxicosis Due to Acute Suppurative Thyroiditis in a Pediatric Patient: A Case Report

McHan

Gupta

2022

Journal of Investigative Medicine High Impact Case Reports

View full text Add to dashboard Cite

Acute suppurative thyroiditis is a rare and potentially life-threatening cause of thyroid inflammation requiring prompt recognition and management. There are few reported cases of thyrotoxicosis due to acute suppurative thyroiditis. We are reporting the case of a 9-year-old boy who presented to the emergency room with fevers, neck pain and swelling, night terrors, and emotional lability. He was hemodynamically stable with initial lab work remarkable for neutrophilia without leukocytosis, elevated inflammatory markers, and hyperthyroidism. Imaging of the neck revealed a heterogenous collection in the region of the left thyroid concerning for suppurative thyroiditis and adenitis. He was admitted to the hospital and initiated on intravenous antibiotics. Given lack of significant improvement in pain, he was taken to the operating room for drainage on hospital day 4 with remarkable clinical improvement in pain. He was discharged on oral antibiotics. Lab work obtained on postoperative day 15 showed resolution of hyperthyroidism and decreasing inflammatory markers. Subsequent imaging following resolution of the acute illness did not reveal any anatomic abnormality that may have predisposed him to developing acute suppurative thyroiditis. Thyrotoxicosis as a complication of acute suppurative thyroiditis is a rare occurrence, and is thought to be due to the release of preformed thyroid hormone from damaged thyroid follicles. The thyrotoxic state is often transient and resolves with appropriate management of acute suppurative thyroiditis. This complication is important to recognize, as failure to appropriately diagnose and treat acute suppurative thyroiditis can lead to poor outcomes, such as airway compromise and death.

show abstract

“…Onset of AST is generally sudden, and the clinical picture progresses very rapidly. Analysis of 1309 thyroid operations performed during twenty‐two years revealed 117 instances of thyroiditis, but only six of these were suppurative . Only 8% of cases occur in adulthood .…”

Section: Discussionmentioning

confidence: 99%