engleski

Thyroid morphology and function in subacute thyroiditis during long-term follow-up

The aim of the present study was to evaluate thyroid morphology and function during the long-term folow-up of patients with subacute (de Quervain's) thyroiditis (SAT). Twenty-four patients (3 men, 21 woman, age range 33-70 years) with citologically proven SAT, were investigated by thyroid hormon testing, Tc-99m scintigraphy and ultrasonography (US) on four occassions: 1) during the initial manifestation of SAT, 2) intermediate - after functional recovery of SAT (2.7-5.8 months, mean 4.7 months), defined as normalization of erythrocyte sedimentation rate (ESR) and normal Tc-99m scan, 3) late - 12 to!5 months, and 4) long-term -4 to 5 years after the onset of SAT. Initially, all patients had an elevated ESR (range 30-120), absent Tc-99m uptake on scan, negative thyroid anti-TPO, all had neck pain, all but two were hyperthyreotic, and all were treated only with non-steroid anti-inflammatory drugs. US demonstrated diffuse decreased echogenicity with no nodular lesion in 4 patients, diffuse decreased echogenicity with nodular lesion in 8, and normal echogenicity with nodular lesion in 12 patients. At the time of intermediate study US showed changed echo structure in all patients with marked echopenic fields in 8, despite of normalisation of thyroid function and scintiscan. At the late study thyroid function was normal, but generalised decreased echogenicity or/with patchy hypoechoic areas are still observed in all patients except four with normal echo texture. Long-term follow-up study showed normalisation of thyroid echogenicity in all patients, but in two which thyroid remained with hypoechoic areas. Thyroid volume was significantly reduced from 24.2 &#177; ; ; ; ; 7.4 ml to 15.4 &#177; ; ; ; ; 6.8 ml (reduction of 38.7 &#177; ; ; ; ; 17.5%, p<0.0001) during recovery. At last study it was 14.5 &#177; ; ; ; ; 5.1 ml, which is maintained at the time of long-term follow-up. In conclusion, permanent echo abnormalities at intermediate and late term study are produced by SAT after completely recovery of thyroid function and normal uptake on Tc-99m scintiscan, but at long-term follow-up thyroid morphology, as assessed bv US, is normalized.

Thyroiditis; Subacute; De Quervain Thyroiditis; Ultrasonography; Follow-Up Studies

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