Endocrine Abstracts

Introduction: Subacute thyroiditis (SAT) is a self-limiting thyroid disease associated with a triphasic clinical course of hyperthyroidism, hypothyroidism, and return to normal thyroid function. The well-known clinical features of SAT include thyroid pain with symptoms of hyperthyroidism, suppressed level of thyroid-stimulating hormone (TSH), low thyroid uptake of radioactive iodine, and elevated erythrocyte sedimentation rate. Diagnosis is based on clinical and laboratory data, and tissue diagnosis is rarely required. Here we report about two cases that developed SAT after dental extraction. Most cases of SAT develop after systemic viral infections like Coxsackie, cytomegalovirus, Epstein Barr virus, and adenovirus. SAT (de Quervain’s) presents typically with neck pain radiating to the ear. To our knowledge there has been no report about SAT developing after dental extraction. The possible complications of tooth extraction is blood loss, impairment of labial sensation, oro-antral fistula, fracture of the abscesses, endocarditis and bacteremia, but SAT has not been reported.

Cases: Our first case was a 45-year-old woman who experienced fever and neck pain after three days of dental extraction. Her sedimentation rate was elevated and hyperthyroidism was detected. She was started steroid treatment with the diagnosis of SAT. After 1 week her symptoms resolved and her sedimentation rate and suppressed TSH levels returned to normal after 1 month. The second patient was a 44-year-old woman who underwent a dental extraction and experienced neck pain after 4–5 days after the procedure. Her sedimentation rate was elevated and FT₄ level was increased and TSH levels was suppressed. Her uptake was low which was performed in another hospital. She was started methyl prednisolone and her symptoms resolved after 1 week and laboratory parameters were normal after 6 weeks.

Conclusion: We have observed two cases experiencing subacute thyroiditis after dental extraction.