Often thyroid diseases are silent disorders even though the gland is enlarged. However there is an exception to this, subacute thyroiditis is a painful condition. Subacute thyroiditis is inflammation of thyroid gland that usually results after a bout of upper respiratory tract infection such as cold and flu. The cause still remains unclear, but medical fraternity relates the condition to be of viral origin.
The condition is rare as compared to other thyroid disorders. Most patients complain of pain and tenderness in neck. Subacute thyroiditis is a self limited disorder and after a short clinical course, thyroid function returns back to normal. In few cases treatment may be necessary. Recurrence is very rare.
What Causes Subacute Thyroiditis?
The exact cause of subacute thyroiditis still remains obscure. However, upper respiratory tract virus infection is suspected to the root cause for development of subacute thyroiditis.Patient presenting with this condition often gives recent history of cold, influenza, mumps and other upper respiratory tract infections.
Middle aged women are more susceptible to this disease as compared to men. It affects predominantly women between 30 and 40 years. According to an estimate, women are ten times more vulnerable to this condition than men. The exact reason why women are affected more still remains unclear.
Besides, few other conditions are known to be associated with subacute thyroiditis. They are;
- Radiotherapy treatment given for Graves’ disease can cause temporary inflammation of thyroid gland.
- It can also occur as a consequence of external radiation given to neck region.
- Patient suffering from renal cell carcinoma is also susceptible to develop subacute thyroidits.
Subacute Thyroiditis Symptoms
The patient appears very sick.
- The most prominent symptom of subacute thyroiditis is pain in neck region. Pain may radiate to other sites, such as the jaw or in the ears. The gland is enlarged in size. It is tender to touch. This pain and swelling can last for weeks and months.
- Systemic symptoms include fever, lassitude, and pain in the throat while swallowing food and water.
- The voice becomes hoarse if enlarged thyroid gland compresses the voice box situated in neck.
- These symptoms are followed by symptoms of hyperthyroidism. The patient may complain of uncontrolled diarrhea, palpitation, tremor of fingers, intolerance to heat, excessive sweating and weight loss.
- After this, the clinical phase shifts towards hypothyroidism. Symptoms which dominate during this period include constipation, fatigue, weight gain, intolerance to cold, swelling of eyelids, etc.
- After a transient state of hyperthyroidism followed by hypothyroidism the condition returns back to normal.
Diagnosis And Treatment Of Subacute Thyroiditis
From obvious symptoms such as pain in throat, swelling and fever, subacute thyroiditis can be easily detected. Certain blood tests further confirm the diagnosis. Blood ESR is very high. Due to inflammation of thyroid gland, the CRP level is very high. It is a clinching diagnostic aid for diagnosing subacute thyroiditis.
Radioactive iodine test does not show presence of iodine in thyroid gland. This helps in differential diagnosis of other thyroid disorders. The diagnosis is confirmed from histopathology report of thyroid gland. For this Fine needle biopsy from thyroid gland is done by the experienced doctor.
Even though subacute thyroditis is a self limiting condition, the purpose of treatment is to alleviate pain and swelling of thyroid gland. It is also aimed at treating the symptoms of hyperthyroidism. To reduce pain, anti-inflammatory medications are used. In severe cases, temporary use of steroids may be necessary to control inflammation.
There is spontaneous recovery from the disease in most cases. It neither gets prolonged nor becomes chronic. The symptoms may last for few weeks to months. In rare cases recurrences occur.