Granulomatous Thyroiditis


De Quervain's thyroiditis, subacute thyroiditis, or Giant Cell Thyroiditis



  • Subacute Thyroiditis is marked by sudden, painful enlargement of the thyroid gland.  It tends to affect young and middle-aged women most often.  The patient usually exhibits evidence of Hyperthyroidism, but Hypothyroidism is not uncommon in this condition.  Generally, it lasts a few weeks or months.  Treatment is usually aimed at controlling the symptoms.  Often, the problem goes away, but may return later.

  • The thyroid gland is usually enlarged and painful.
  • Sometimes the pain from the Thyroiditis shoots into the ear area.
  • If the thyroid gland becomes very large, it may cause pain and/or difficulty swallowing.
  • Rarely, pain may be absent.  This is called silent Thyroiditis.
  • Symptoms of hyperthyroidism (Palpitations, fibrillation, rapid pulse, tremor, sweating, nervousness, fatigue, Goiter, heat intolerance, emotional swings, characteristic "bulging eyes," etc.) are common.
  • Some will feel very weak and tired.
  • A small number of cases may become hypothyroid.
  • If the thyroid gland is enlarged, it may put pressure on other structures in the neck.

  • It is not known what exactly causes the disease, but some think that it may be due to a viral infection.

  • Symptoms and examination help make the diagnosis.
  • Lab tests may show high ESR (Erythrocyte sedimentation rate), low anti-thyroid antibodies, and low uptake of radioactive iodine (thyroid scan).
  • Biopsy may be needed to confirm diagnosis, but usually it is not necessary.

  • Treatment depends on whether the patient is hyperthyroid or hypothyroid.
  • Hyperthyroidism is treated with a medicine called propranolol, which helps control the symptoms.
  • Hypothyroid requires thyroid hormone supplements.
  • For pain and swelling, aspirin can be used.
  • Treatment is usually continued for several weeks.
  • Treatment is directed primarily at controlling the symptoms.
  • The disease usually runs its own course and, after some time, it goes away.
  • However, the disease may come back in some people.
  • The overall prognosis is very good.