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Subacute thyroiditis is marked
by sudden, painful enlargement of the thyroid gland. It tends to affect young and middle-aged women most often. The patient usually exhibits evidence of hyperthyroidism, but hypothyroidism is not
uncommon in this condition. Generally, it lasts a few weeks or months. Treatment is usually aimed at controlling the symptoms. Often, the problem goes away, but may return later.
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- The thyroid gland is usually
enlarged and painful.
- Sometimes the pain from the thyroiditis shoots
into the ear area.
- If the thyroid gland becomes very
large, it may cause pain and/or difficulty swallowing.
- Rarely, pain may be absent. This is called silent thyroiditis.
- Symptoms of hyperthyroidism (Palpitations, fibrillation, rapid pulse, tremor, sweating, nervousness, fatigue, goiter, heat intolerance,
emotional swings, characteristic "bulging eyes," etc.) are
common.
- Some will feel very weak and tired.
- A small number of cases may become
hypothyroid.
- If the thyroid gland is enlarged, it may put pressure on other structures in the neck.
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- It is not known what exactly causes the disease, but some think that it may be due to a viral infection.
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- Symptoms and examination help make
the diagnosis.
- Lab tests may show high ESR (Erythrocyte sedimentation rate), low anti-thyroid antibodies, and low
uptake of radioactive iodine (thyroid scan).
- Biopsy may be needed to confirm diagnosis, but usually it is not necessary.
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- Treatment depends on whether the
patient is hyperthyroid or hypothyroid.
- Hyperthyroidism is
treated with a medicine called propranolol, which helps
control the symptoms.
- Hypothyroid requires thyroid
hormone supplements.
- For pain and swelling, aspirin can
be used.
- Treatment is usually continued for
several weeks.
- Treatment is directed primarily at
controlling the symptoms.
- The disease usually runs its own
course and, after some time, it goes away.
- However, the disease may come back
in some people.
- The overall prognosis is very good.
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