Pharyngitis, Sturzsenkung und Hyperthyreose bei einer 71-j�hrigen Patientin

Raupach, Tobias; Karaus, M.

doi:10.1007/s00108-004-1259-7

Cited by 2 publications

(1 citation statement)

References 19 publications

(34 reference statements)

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“…Symptomatic management with analgesics, beta blockers and sometimes with oral steroids in various pharmacological dosages cause rapid relief of pain and fever, in addition to the role in decreasing recurrence rate in subacute thyroiditis [16] whereas patients with hyperthyroidism are managed initially with thionamides and beta blockers [17].…”

Section: Introductionmentioning

confidence: 99%

Profile of thyrotoxic patients presenting as pyrexia of unkown origin: An observational case study from a tertiary care hospital

Pala

Kashmir

Ashraf³

et al. 2019

Int J Med Res Rev

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Objective: To study the profile of thyrotoxic patients evaluated for pyrexia of unknown origin (PUO). Methods: 25 patients, who were evaluated for pyrexia of unknown origin and found to have thyrotoxicosis as the cause for fever, were managed as per the recommended protocol and followed for 12 months. Results: All the patients were presumed to have infectious fever and had received antibiotics prior to diagnosis. Out of 25 patients, 20 (80%) had subacute thyroiditis (SAT) and 5 (20%) had hyperthyroidism (4 had Graves disease and 1 toxic adenoma). Patients with hyperthyroidism received thionamides and β-blockers. 50% patients with subacute thyroiditis received analgesics, 25% received steroids only and 25% received a combination of analgesics and steroids. Early-onset transient hypothyroidism occurred in 40% patients with SAT, permanent hypothyroidism was less common and only 15% of patients were receiving levothyroxine therapy after one year of follow-up. Conclusion: Thyrotoxicosis should always be included in the differential diagnosis while evaluation of patients with PUO. Most of the patients with thyrotoxicosis are wrongly misinterpreted as infectious PUO and given unnecessary antibiotics. Early-onset transient hypothyroidism is common in SAT compared to permanent hypothyroidism. Although, symptomatic relief is achieved with analgesics and steroids but does not prevent the development of hypothyroidism.

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Section: Introductionmentioning

confidence: 99%

Profile of thyrotoxic patients presenting as pyrexia of unkown origin: An observational case study from a tertiary care hospital

Pala

Kashmir

Ashraf³

et al. 2019

Int J Med Res Rev

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Treatment of Acute Painful Thyroiditis with Low Dose Prednisolone: A Study on Patients from Western Nepal

Koirala

Sharma

2015

JCDR

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IntrOductIOnThyroiditis is defined as a disorder that involves inflammation of the thyroid gland. Thyroiditis is mainly divided into two broad categories: painless and painful. Among the category of painful types of thyroiditis is subacute (de Quervain's thyroiditis) which is the most common cause of acute painful thyroiditis [1]. The patients usually present to the otorhinologists with complaints of neck pain, swelling and odynophagia. On examination, there is tenderness at the region of thyroid gland. Although the exact aetiology is unknown, is thought to be a viral inflammatory disorder [2]. The disorder is usually selflimiting over months with a triphasic course of hyperthyroidism followed by hypothyroidism and ending with euthyroidism.Subacute thyroiditis has been treated with either nonsteroidal anti-inflammatory drugs (NSAIDs) or corticosteroids for years. The response to steroids is often more dramatic and quicker than the response to NSAIDs, but steroids are well known for their side effects over NSAIDs. As subacute thyroiditis is a self-limiting condition, high dose of steroids might be irrelevant to some people. The usual initial dose is 1 mg/kg of prednisolone per day and tapered over six weeks although the basis for this dose has not been established yet by prospective studies [3].The current study was carried out to study if prednisolone in lower initial dose (20 mg/day tapered over four weeks) is effective in patients with acute painful thyroiditis. Thyroid tenderness and Erythrocyte Sedimentation Rate (ESR) were taken as the guidelines to either continue or discontinue the drug. The patients were followed up carefully and data were analysed. MAterIAls And MethOdsThis study was a prospective, cross sectional, observational study carried out in the Department of ENT, Manipal Teaching Hospital, Pokhara, Nepal from 1 st August 2012 to 31 st March 2015. All the patients with acute anterior neck pain of less than or equal to seven days duration were included in the study. Diagnosis was made in the clinical grounds according to history of anterior neck pain, tenderness thyroid region, tender and swollen thyroid gland, ultrasound of the neck showing increased vascularity of the thyroid gland and raised Erythrocyte Sedimentation Rate (ESR).Patients with clinical signs suggestive of subacute thyroiditis and ESR of more than 30 mm/h were finally included in the treatment group.Patients in whom there was contraindication to the use of prednisolone (severe gastritis, Diabetes, hypertension) were excluded from the study.The patients were administered prednisolone in a starting dose of 20 mg/day (10 mg twice daily) tapered over four weeks. The dose was 10 mg twice daily for 2 weeks and 10 mg once daily day for next 2 weeks. They were also co-prescribed with pantoprazole 40 mg twice daily for 2 weeks to lessen the gastric irritation caused by prednisolone. A performa was made, initial findings of severity of pain and tenderness and ESR were noted, and patients were closely observed for 4 weeks. ESR was repeated ...

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Pharyngitis, Sturzsenkung und Hyperthyreose bei einer 71-j�hrigen Patientin

Cited by 2 publications

References 19 publications

Profile of thyrotoxic patients presenting as pyrexia of unkown origin: An observational case study from a tertiary care hospital

Profile of thyrotoxic patients presenting as pyrexia of unkown origin: An observational case study from a tertiary care hospital

Treatment of Acute Painful Thyroiditis with Low Dose Prednisolone: A Study on Patients from Western Nepal

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