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|
|Number of pages||2|
|Journal||CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne|
|Publication status||Published - 4 Oct 2021|