De Quervain’s thyroiditis, is the most common form of subacute thyroiditis. The exact cause of De Quervain’s thyroiditis is unknown, but it is believed to be associated with viral infections of the upper respiratory tract, although there is currently no conclusive medical evidence to support this.

De Quervain’s thyroiditis most commonly affects middle-aged women. Patients experience sudden pain in the thyroid gland area of the neck, which may radiate to the jaw or ears. The pain worsens with chewing and swallowing. The patient’s thyroid gland shows signs of inflammation and swelling. Due to the destruction of thyroid cells, stored thyroid hormone is released into the bloodstream, resulting in a dramatic increase in thyroid hormone levels, leading to hyperthyroidism. Patients may experience symptoms such as rapid heartbeat, palpitations, insomnia, heat intolerance, irritability, and significant weight loss. These symptoms can persist for several weeks.

Thyroid inflammation usually subsides within a few weeks, and the neck pain resolves. However, since the stored thyroid hormone within the thyroid gland has been depleted, patients experience severe thyroid hormone deficiency, resulting in hypothyroidism. As a result, patients may experience symptoms such as loss of appetite, fatigue, slow heartbeat, low mood, depression, and weight gain. These symptoms may persist for several weeks to months.

Eventually, as the thyroid tissue slowly repairs itself, thyroid function gradually recovers within a few months, and the symptoms of hypothyroidism subside. The majority of patients make a full recovery, with only about 5% of patients developing permanent hypothyroidism. The recurrence rate is approximately 5% thereafter.

Clinical diagnosis is the primary method for diagnosing De Quervain’s thyroiditis. The doctor will inquire about the patient’s medical history in detail and perform a clinical examination for diagnosis. During the clinical examination, there will be noticeable swelling and tenderness in the neck area near the thyroid gland.

Blood tests to measure the levels of thyroid hormones T4, T3, and thyroid-stimulating hormone (TSH) can help the doctor assess the patient’s thyroid function and determine the stage of thyroid inflammation. The level of thyroid protein (thyroglobulin) in the blood may also be elevated due to the release of thyroid hormones into the bloodstream as a result of thyroid cell damage.

Ultrasound imaging and ultrasound-guided fine-needle aspiration can further assist in the diagnosis. Cellular examination of the aspirated material can reveal the presence of giant cells.

Depending on the stage of thyroiditis and the patient’s condition, doctors will prescribe corresponding treatment methods.

If the patient’s condition is in the early stage, meaning that the thyroid is still in the acute inflammatory stage and the patient is experiencing neck pain, doctors will prescribe non-steroidal anti-inflammatory drugs (NSAIDs) as the first-line treatment. In more severe cases, steroid therapy may be necessary.

Doctors will prescribe medication based on the patient’s thyroid levels. If the patient has symptoms of hyperthyroidism, beta-blockers may be used to alleviate those symptoms.

If the patient has hypothyroidism, doctors will prescribe thyroid hormone replacement therapy to balance the patient’s thyroid hormone levels.

In the majority of cases, thyroid function will gradually recover within a few weeks to several months, and only about 5% of patients will require long-term thyroid hormone replacement therapy.