Epidemic pattern. Male/female = 1:4; 1:6 as common as nonstimulating autoimmune thyroid disease; 1/8 as common as stimulating autoimmune thyroid disease. 1/3 of cases follow a URI
Sx:Many sx (in contrast to Hashimoto's) including fever, nervousness, tender painful neck
Si:Firm gland, usually tender, although 15% have no goiter or pain (Ann IM 1977;86:24)
months 1-2: hyperthyroid with tender gland
month 3: transition with firm nontender gland
months 4-6: hypothyroid with firm gland becoming normal
months 7+: return to normal function and exam
r/o ACUTE PYOGENIC THYROIDITIS; hemorrhage into thyroid nodule; amiodarone thyrotoxicosis
Lab:
Hem:ESR 50-80 mm/h early in course
Serol:Occasionally (20%) positive antithyroid antibodies
Xray:Thyroid131 ,I123,I or technetium scan shows no uptake; low RAIU
Rx:Palliative, no effect on course, including: salicylates; short-term steroids, eg, prednisone 40 mg qd, taper to 20 mg qd over 2 wk; ß-blockers when toxic sx, replacement rx when hypo