Rotondi M, Capelli V, Locantore P, Pontecorvi A, Chiovato L
Unit of Internal Medicine and Endocrinology, ICS Maugeri I.R.C.C.S., Chair of Endocrinology, University of Pavia, Via S. Maugeri 10, 27100, Pavia, Italy.
Experimental Medicine, University of Pavia, Pavia, Italy.
J Endocrinol Invest. 2017 Aug;40(8):815-818. doi: 10.1007/s40618-017-0655-5. Epub 2017 Mar 24.
Neck pain is a common complain, being in most cases due to non-thyroidal causes. However, a minority of patients suffer from painful thyroid diseases. Among them, sub-acute thyroiditis (SAT) is the most frequent one. Rare thyroid-related causes of neck pain include hemorrhage within a thyroid nodule as well as Riedel's thyroiditis and suppurative thyroiditis. In the last 30 years, a few cases of a painful variant of Hashimoto's thyroiditis (HT) have been described. Biochemical, ultrasound, and histologic features were clearly suggestive for HT in all of the published cases and definitely ruled out the diagnosis of SAT. While sound descriptions of painful HT are present in the literature, it is important to emphasize that only 20 cases were reported from the year 2000 until now. The condition, however, is clinically relevant because neck pain was reported to be refractory both to steroids and to other analgesic drugs, being thyroidectomy the only effective treatment for pain relief in these patients. This short review analyzes currently available data supporting a role for HT as a rare cause of neck pain.
颈部疼痛是一种常见的主诉，在大多数情况下是由非甲状腺原因引起的。然而，少数患者患有疼痛性甲状腺疾病。其中，亚急性甲状腺炎（SAT）最为常见。罕见的与甲状腺相关的颈部疼痛原因包括甲状腺结节内出血以及Riedel甲状腺炎和化脓性甲状腺炎。在过去30年中，已经描述了几例桥本甲状腺炎（HT）的疼痛变体。在所有已发表的病例中，生化、超声和组织学特征均明确提示为HT，并明确排除了SAT的诊断。虽然文献中有关于疼痛性HT的详细描述，但需要强调的是，从2000年至今仅报道了20例。然而，这种情况在临床上具有相关性，因为据报道颈部疼痛对类固醇和其他镇痛药均无效，甲状腺切除术是这些患者缓解疼痛的唯一有效治疗方法。这篇简短的综述分析了目前可用的数据，支持HT作为颈部疼痛罕见原因的作用。
