deQuervain's thyroiditis - hypothyroidism or not?

[johndoe3344]

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FA (2011, p298) says about Subacute (de Quervain's) thyroiditis: self-limited hypothyroidism often following a flulike illness. May be hyperthyroid early in course. [this wasn't corrected by an errata]

Pathoma (p 163) says that it is self-limited and does NOT progress to hypothyroidism. This is a fact that Dr. S himself emphasized in his videos (unlike the other problem with the MVP murmur where it was just in the text, and he skipped over mentioning it in the videos)

Can someone resolve the contradiction?

 

[shan564]

I've seen a couple of questions (I think one was on UW and the other was Kaplan) where people with DeQuervain's had hypothyroidism. Medscape says that the initial hyperthyroidism is "sometimes followed by hypothyroidism."

 

[kaleerkalut]

FA (2011, p298) says about Subacute (de Quervain's) thyroiditis: self-limited hypothyroidism often following a flulike illness. May be hyperthyroid early in course. [this wasn't corrected by an errata]

Pathoma (p 163) says that it is self-limited and does NOT progress to hypothyroidism. This is a fact that Dr. S himself emphasized in his videos (unlike the other problem with the MVP murmur where it was just in the text, and he skipped over mentioning it in the videos)

Can someone resolve the contradiction?

I just read this in RR today. From what I understood, it initially causes hyperthyroidism. Following this there is a short period of hypothyroidism that then returns to a euthyroid state.

 

[chiefMD]

yup. you get an intial hyperthryroidism due to all the thyroid hormone stored up that is released, then it is followed by hypothyroidism. usually self resolves. most questions will deal with how to identify it by histology, symptoms, etc..not whether the pt was in or will be in hyperthyroidism, etc..

 

[ijn]

Yeah - a painful thyroid on palpation is probably what they're going to give you (or granulomatous inflammation from an FNA), and I don't think we're responsible for knowing of any other condition that can result in those symptoms.

 

[Aclamity]

Initial hyperthyroidism (and pain) from inflammation/rupture of follicles --> release of T4

Potentially hypothyroidism after the initial hyperthyroidism

Self-limited because it's due to viral causes; once the virus is gone and inflammation subsides you 're back to euthyroid state.

I agree with everyone else though that the histology is probably most important