Endocrine Abstracts

Subacute thyroiditis (SAT) is a self-limited inflammatory condition of the thyroid characterised by a clinical course of hyperthyroidism, hypothyroidism, and then return to normal thyroid function. The inflammation is thought to be triggered by a viral infection and is usually treated with anti-inflammatory medications and steroids. Recurrences can uncommonly occur and could be difficult to manage. There are some promising reports of the role of Colchicine in managing recurrent SAT. Here we report two SAT case scenarios where colchicine was found useful. Case 1: A 28-year-old female athlete who presented with hyperthyroidism caused by 4^th recurrence of SAT. Previously she was managed with tapering Prednisolone therapy and remained on a small dose of Prednisolone for a long time since the 3^rd recurrence before weaned off slowly; however, she had the 4^th recurrence within 4 months. She was restarted on a tapering course of Prednisolone, and based on some recent evidence, Colchicine was started. She hasn’t shown any sign of recurrence since. Case 2: A 47-year-old female who developed fever, tachycardia and thyroid tenderness eight months after SARS-CoV-2 infection. Laboratory tests and nuclear imaging were indicative of subacute thyroiditis. She had initial response to high dose of prednisolone however it relapsed after stopped. She had persistent tachycardia which was thought to be due to pericarditis. She was started on Colchicine for this, but only took it for two weeks due to intolerance. However, she did complete a second course of prednisolone and is currently euthyroid. Our cases have demonstrated that Colchicine, as an anti-inflammatory agent, may provide a steroid-sparing method in managing difficult SAT and prevent recurrence. In addition, increasing reports have shown SAT as a part of systemic inflammation caused by SARS-CoV-2 virus. Colchicine could be a treatment choice in this scenario. Further large study is required.