De Quervain's thyroiditis

Abstract

Thyroiditis is an inflammation (not necessarily an infection) of the thyroid gland. Inflammatory diseases, are the most common thyroid disorders encountered in clinical practice. Some of these present to the otolaryngologists, as painful deglutition or odynophagia, which can be a very distressing symptom. They may also present as neck pain, sore throat, neck mass or even dyspnoea. Singer classified inflammatory diseases of the thyroid into three broad categories: acute, subacute and chronic thyroiditis. Subacute disease includes granulomatous or De Quervain's thyroiditis and lymphocytic thyroiditis or silent thyroiditis. The chronic group includes chronic lymphocytic (Hashimoto's thyroiditis) and invasive fibrous (Riedel's) thyroiditis [1]. De Quervain's thyroiditis was first described in 1904 and is much less common than Hashimoto's thyroiditis and may be missed if not looked for in a case of odynophagia. The gland swells up and is very painful and tender. As thyroid hormones are discharged into the blood, patient becomes hyperthyroid but the gland cannot take up iodine so the radioactive iodine uptake is very low. The hyperthyroidism generally resolves after a few weeks. The relief of pain by giving steroids in this condition is so dramatic as to be almost diagnostic. Such a case who went from pillar to post for more than 3 weeks, before a diagnosis was made is being reported, to increase awareness of this not so common disorder among clinicians [2].