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Subacute thyroiditis

Última revisão: 8 Aug 2025
Última atualização: 24 Jan 2023

Resumo

Definição

História e exame físico

Principais fatores diagnósticos

  • neck pain
  • tender, firm, enlarged thyroid
  • fever
  • palpitations
Detalhes completos

Outros fatores diagnósticos

  • recent viral infection
  • myalgia
  • malaise
  • tremor
  • heat intolerance
Detalhes completos

Fatores de risco

  • viral infection
  • Certain HLA and B35 alleles
Detalhes completos

Investigações diagnósticas

Primeiras investigações a serem solicitadas

  • serum thyroid-stimulating hormone (TSH)
  • serum total T4, total T3, free T3, free T4 index, and free T4
  • T3:T4 ratio
  • radioactive iodine uptake
  • Serum ESR
  • Serum CRP
  • Serum thyroid antibodies (thyroid peroxidase antibodies [TPO Ab])
Detalhes completos

Investigações a serem consideradas

  • fine needle aspiration biopsy
  • complete blood count
Detalhes completos

Novos exames

  • ultrasonography of thyroid

Algoritmo de tratamento

AGUDA

hyperthyroid (thyrotoxic) phase

hypothyroid phase

Colaboradores

Autores

Angela M. Leung, MD, MSc

Associate Professor of Medicine

UCLA David Geffen School of Medicine

VA Greater Los Angeles Healthcare System

Los Angeles

CA

Declarações

AL has served on the board of directors of the American Thyroid Association. She is editor-in-chief of Clinical Thyroidology, a journal of the American Thyroid Association. AL is a speaker for Medical Education Resources and MCE Conferences. She has consulted for Vertice Pharma and received article process charges paid by IBSA Institut Biochimique for an invited review article. AL has lectured at a conference sponsored by Merck and presented educational content for the Endocrine Society and the American Association of Clinical Endocrinology. AL is an advisor to Medscape and has received research funding from the U.S. Dept of Veterans Affairs.

Agradecimentos

Dr Angela M. Leung would like to gratefully acknowledge Dr Stephanie L. Lee, the previous contributor to this topic.

Declarações

SLL declares that she has no competing interests.

Revisores

Georg Hennemann, MD

Professor of Medicine and Endocrinology

Medical Center Spijkenisse

The Hague

The Netherlands

Declarações

Not disclosed.

Ronald Merrell, MD

Professor of Surgery

Virginia Commonwealth University

Richmond

VA

Declarações

RM declares that he has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

Referências

Nossas equipes internas de editoria e de evidências trabalham em conjunto com colaboradores internacionais especializados e pares revisores para garantir que forneçamos acesso às informações o mais clinicamente relevantes possível.

Principais artigos

Nishihara E, Ohye H, Amino N, et al. Clinical characteristics of 852 patients with subacute thyroiditis before treatment. Intern Med. 2008;47(8):725-9. Resumo

Stasiak M, Lewiński A. New aspects in the pathogenesis and management of subacute thyroiditis. Rev Endocr Metab Disord. 2021 Dec;22(4):1027-39.Texto completo  Resumo

Ross DS, Burch HB, Cooper DS, et al. 2016 American Thyroid Association guidelines for diagnosis and management of hyperthyroidism and other causes of thyrotoxicosis. Thyroid. 2016 Oct;26(10):1343-421.Texto completo  Resumo

Alexander EK, Pearce EN, Brent GA, et al. 2017 guidelines of the American Thyroid Association for the diagnosis and management of thyroid disease during pregnancy and the postpartum. Thyroid. 2017 Mar;27(3):315-89.Texto completo  Resumo

Artigos de referência

Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.
  • Subacute thyroiditis images
  • Diagnósticos diferenciais

    • Graves disease
    • Infectious, suppurative, or acute thyroiditis
    • Toxic multinodular goiter
    Mais Diagnósticos diferenciais
  • Diretrizes

    • Thyroid disease: assessment and management
    • 2017 guidelines of the American Thyroid Association for the diagnosis and management of thyroid disease during pregnancy and the postpartum
    Mais Diretrizes
  • Folhetos informativos para os pacientes

    Underactive thyroid

    Mais Folhetos informativos para os pacientes
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