Endocrine Abstracts

Introduction: Subacute thyroiditis (SAT) is most common cause of painful thyroiditis. Although prednisolone at 40 mg/d has been preferred as initial dose for moderate to severe SAT, there have also been other recommendations as 25–60 mg/day in many reports. We retrospectively assessed the effect of steroid dose on the SAT.

Methods: We examined 132 patients with SAT who visited our endocrinology clinic at least three times between January 2005 and December 2012. We excluded patients without high ESR level, steroid prescription, and follow-up within 6month after resolution. Final number of subjects was 63. The outcome in the group with initial steroid dose less than 30 mg (n=22, 34.9%) was compared with that with 30 mg or more (n=41, 65.1%).

Results: The mean age of the total patients was 48.2 years. The incidence was most prevalent from September to November (40%, n=26). The mean of initial prednisolone dose was 30.2 mg, while tapering steroid dosage for the mean duration of 7.6 weeks. Six patients (9.5%) have relapsed within 6 months. The clinical outcome in the group with less dosage was not significantly different from that in the group with more dosage, such as total administration period (P=0.804), the recurrence rate (P=0.423), TSH (P=0.826), free T4 (P=0.072), ESR (P=0.079), 99 m-Technisium thyroid scan uptake (P=0.185). Although no serious side effect was observed, three cases of epigastric discomfort and swelling was reported in higher dosage group.

Conclusion: In our study, the initial dosage for the treatment of SAT with less than 30mg appeared as effective as 30 mg or more. Relapse of SAT seemed not dependent on the initial dose of prednisolone.