SUB-ACUTE THYROIDITIS: ESR AS DIAGNOSTIC MARKER AND OPTIMUM DURATION OF PREDNISOLONE THERAPY

Abstract

BACKGROUND: Thyroiditis is an inflammation of the thyroid gland that can arise due to a variety of
causes. Subacute thyroiditis or de Quervain thyroiditis is comparatively uncommon with recurrence rate
of 5% patients over a 20-year period. It usually presents in the form of epidemics and mostly has
overlapping symptoms, which leads to misdiagnosis.
OBJECTIVE: To study sub-acute thyroiditis with the risks and benefits of treatment and consequences
of non treatment.
PATIENTS AND METHODS: The study was conducted on seventy (70) patients who visited for
consultancy during April 2014 to May 2015. Their mean age was 37 years, having 28 male 42 females.
Those who presented with symptoms of pain in front of neck, unilateral or bilateral, periodic generalized
body aches, without having history of high grade fever, were included in the study after taking their
consent. ESR, TFTs and complete blood picture of those having mildly enlarged or not palpable,
painful and tender thyroid were done and recorded. They were divided into various groups for steroid
therapy. The patients were selected randomly.
RESULTS: All the seventy patients having symptoms, suggestive of thyrioditis had markedly raised
ESR with normal TFTs range and rest of the blood picture, were put on 40-45mg/day with tapering dose
for two to six weeks. Those who were put on six weeks steroid therapy had no recurrence, where as
those with duration less than six weeks time suffered from recurrence of symptoms.
CONCLUSION: Subacute thyroditis presented with generalized bodyach and tender thyroid gland with
raised ESR, when treated with 40-45mg/day prednisolone therapy for six weeks responded significantly.
KEY WORDS: Thyroiditis, Subacute thyroiditis, Erythrocyte sedimentation rate, Steroid therapy.