Table 1.
Seventy-three patients with painful thyroiditis observed in the years 1996–2013; clinical and laboratory details∗.
| Clinical details | Subgroups | Data∗∗ |
|---|---|---|
| Age; years, range, and (median) | 14.4–75.2 (42.8) | |
|
| ||
| Sex | Females | 58 |
| Males | 15 | |
|
| ||
| Systemic symptoms and/or fever | Yes | 53 |
| No | 20 | |
|
| ||
| Transient thyrotoxicosis | Yes | 44 |
| No | 29 | |
|
| ||
| TPOAb and/or TgAb levels | Above reference range | 19 |
| Absent and/or within reference range | 43 | |
| Unknown | 11 | |
|
| ||
| TRAb in patients with transient thyrotoxic | Positive | 0 |
| Negative | 35 | |
| Unknown | 9 | |
|
| ||
| Thyroid function in 43 cases with absent or normal TPOAb and TgAb | Transient thyrotoxicosis | 28 |
| Euthyroidism during the observation period | 15 | |
|
| ||
| Thyroid function in 19 patients with positive TPOAb and/or TgAb | Transient thyrotoxicosis | 9 |
| Euthyroidism during the observation period | 6 | |
| Already on treatment with thyroxine for hypothyroidism | 3 | |
| euthyroid → Graves' disease∗∗∗ | 1 | |
|
| ||
| Thyroid nodules at ultrasonography | Yes | 22 |
| No | 49 | |
|
| ||
| Treatment schedule and outcome∗∗∗∗ | Responders to salicylates or NSAIDs | 11 |
| Responders to steroids∗∗∗∗∗ | 60 | |
| Not responders to steroids (this paper, Cases 2 and 3) | 2 | |
∗Data are expressed in number of subjects when not otherwise specified in the column “clinical details.”
∗∗ TPOAb: thyroid peroxidase antibodies; TgAb: thyroglobulin antibodies; TRAb: thyrotropin receptor antibodies.
∗∗∗This patient was euthyroid during the painful phase; about three months after the resolution of painful thyroiditis the patient developed persistent thyrotoxicosis with positive TRAb, necessitating treatment with an antithyroid drug.
∗∗∗∗Before our observation, 18 patients were unsuccessfully treated with antibiotics; steroids were also sometimes used before our observation, but at doses lower than those subsequently found to be effective.
∗∗∗∗∗Patients were treated with prednisone 10–40 mg daily (58 cases) or other steroids in equivalent doses (2 cases). After 7–35 days (median 16) a gradual reduction in dosage could be initiated. Remission occurred in 57 patients. During the period of reduction of dosage or after discontinuation a single relapse was observed in 3 cases, all controlled with restoration of higher steroid dosage.