Abstract
A 41-year-old woman presented to hospital with anterior neck swelling and pain, made worse with swallowing, after a week of febrile upper respiratory illness. She had an exquisitely tender goitre and fine hand tremor. Her temperature was 37.1°C, with a resting heart rate of 92–122 beats/minute and blood pressure of 116/68 mm Hg. Her thyroid-stimulating hormone was undetectable at < 0.01 (normal range 0.35–5.50) mU/L, with elevated free thyroxine (59.0 pmol/L; normal range 10.0–20.0), and free triiodothyronine (27.4 pmol/L; normal range 3.5–6.5). Her C-reactive protein and erythrocyte sedimentation rate were also elevated (Appendix 1, available at www.cmaj.ca/lookup/doi/10.1503/cmaj.202787/tab-related-content). The emergency physicians excluded suppurative thyroiditis and thyroid abscess by computed tomography (CT), which showed thyroid enlargement (Figure 1). An endocrinologist diagnosed subacute thyroiditis and prescribed a short course of oral prednisolone, ibuprofen and propranolol; the patient’s pain and goitre size reduced within 24 hours. After discharge from hospital, her symptoms resolved without further intervention, followed by a period of asymptomatic hypothyroxinaemia, eventually returning to euthyroidism (Appendix 1).
Translated title of the contribution | De Quervain subacute thyroiditis |
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Original language | French |
Pages (from-to) | E1549-E1550 |
Number of pages | 2 |
Journal | CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne |
Volume | 193 |
Issue number | 39 |
DOIs | |
Publication status | Published - 4 Oct 2021 |