Endocrine Abstracts

Aim: Thyrotoxicosis is a clinical status related to increased thyroid hormones. It is caused by either hyperfunctioning thyroid tissue or destruction of thyroid. Subacute thyroiditis, also known as De Quervain or granulomatous thyroiditis, is an acute inflammatory disease of thyroid causing thyrotoxicosis. Clinical and laboratory features vary according to the course of disease. In this study, we aimed to study clinical and laboratory features of the patients who were referred from internal medicine outpatient clinics to endocrinology department due to thyrotoxicosis.

Methods: We retrospectively evaluated electronic data of 32 patients who were followed-up by endocrinologists due to subacute thyroiditis in 2013–2018. Thyroid function tests, presence of antibodies, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), onset of disease, achievement of euthyroidism, department of initial admission, and thyroid scintigraphy results where available.

Results: Twenty six (81.2%) patients were female. Twelve patients (37.5%) first attended to ear-nose-throat department, 8 (25%) to family medicine practitioner, 6 (18.8%) to internal medicine specialist, and 6 (18%) to general surgery departments due to complaints. Eight (25%) were attended to the outpatient clinics in spring, 7 (21.9%) in summer, 12 (37.5%) fall, and 5 (15.6%) in winter. Mean age was 42.9±9.1 (33–69). Four patients’ sera (12.5%) were positive for anti thyroglobulin antibody. Mean TSH level was 0.015±0.024 μIU/ml (0.35–4.94), free T4 level 2.17±0.77 ng/dl (0.7–1.48), free T3 level 5.74±2.53 ng/dl (1.71–3.71), ESR 73.3±17.3 mm/h (0–20), and CRP 55.5±37.3 mg/l (0–8). Nineteen patients had scintigraphy. All yielded suppressed uptake in thyroid bed. Two (6.3%) patients developed permanent hypothyroidisim. Mean time lapse till achieving euthyroidism was 3.8±2.9 months in 29 patients.

Discussion: Subacute thyroiditis must be kept in mind in differential diagnosis of thyrotoxicosis for correct diagnosis ve management.