Diabetes, Endocrinology and Metabolic Disease Institute, Kaplan Medical Center, The Faculty of Medicine, Hebrew University of Jerusalem, Rehovot 9190401, Israel.
Internal Medicine Department, Kaplan Medical Center, Rehovot 9190401, Israel.
Int J Environ Res Public Health. 2022 Jul 31;19(15):9388. doi: 10.3390/ijerph19159388.
Subacute thyroiditis (SAT) is a relatively common cause of thyroid disease. However, only a few studies evaluating SAT have been published in recent years with varying diagnostic criteria. We evaluate the clinical presentation and long-term outcome of isotope scan-confirmed SAT. A retrospective study of 38 patients with isotope scan-confirmed SAT was performed at a single isotope department. All patients were contacted for long-term follow-up. The female/male ratio was 1.4:1, and mean age was 47 ± 14 years and 62 ± 12 years in women and men, respectively ( = 0.002). Almost half of the cases (42%) occurred during the summer. The most common symptoms were neck pain (74%) and weakness (61%). Palpitations, weight loss, heat intolerance, and sweating appeared in 50%, 42%, 21%, and 21%, respectively. Only half of the patients reported fever. TSH level was low in all patients, and mean FT4 and FT3 level were about twice the upper limit of normal range. Elevated CRP and ESR occurred in the majority (88%) of patients. The mean time period between the first clinic visit and performing thyroid function tests was 8 ± 7 days. One-third of the patients initially received a diagnosis of upper respiratory tract infection (URI). NSAIDs and steroids were prescribed to 47% and 8% of patients, respectively. Long-term follow-up of 33.5 months (range 9-52) revealed that 25% remained with subclinical or overt hypothyroidism. These data demonstrate that although SAT is a common entity, there is still a significant delay in diagnosis, and in a third of our patients, the initial diagnosis was URI, with 25% developing long-term hypothyroidism.
亚急性甲状腺炎（SAT）是一种相对常见的甲状腺疾病。然而，近年来仅有少数研究评估 SAT，且其诊断标准各不相同。我们评估了经同位素扫描证实的 SAT 的临床特征和长期结局。在一个同位素部门进行了一项回顾性研究，纳入了 38 例经同位素扫描证实的 SAT 患者。所有患者均接受了长期随访。女性/男性的比例为 1.4:1，女性和男性的平均年龄分别为 47 ± 14 岁和 62 ± 12 岁（= 0.002）。将近一半的病例（42%）发生在夏季。最常见的症状是颈痛（74%）和乏力（61%）。心悸、体重减轻、怕热和多汗分别出现在 50%、42%、21%和 21%的患者中。仅有一半的患者报告发热。所有患者的 TSH 水平均降低，FT4 和 FT3 水平均值约为正常上限的 2 倍。大多数患者（88%）的 CRP 和 ESR 升高。首次就诊和进行甲状腺功能检查之间的平均时间间隔为 8 ± 7 天。三分之一的患者最初被诊断为上呼吸道感染（URI）。分别有 47%和 8%的患者接受了 NSAIDs 和皮质类固醇治疗。33.5 个月（9-52 个月）的长期随访显示，25%的患者仍存在亚临床或显性甲状腺功能减退症。这些数据表明，尽管 SAT 是一种常见疾病，但仍存在显著的诊断延迟，在我们的三分之一患者中，最初的诊断是 URI，其中 25%的患者发展为长期甲状腺功能减退症。
