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Extent of hypoechogenic area in the thyroid is related with thyroid dysfunction after subacute thyroiditis

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Abstract

Objective: To gain an insight into risk factors for hypothyroidism after subacute thyroiditis (SAT), we examined the correlation between initial laboratory and ultrasonographic findings and sequential thyroid dysfunction among treatment modalities. Patients: We reviewed retrospectively the medical records of 252 patients (26 men and 226 women) with SAT who consecutively visited our thyroid clinic at Kuma Hospital for at least 6 months from 1996 through 2004. Results: Throughout the course, 135 patients (53.6%) developed transient or permanent hypothyroidism. Levels of TSH were most often elevated (greater than 5 IU/ml) 2 months after SAT onset regardless of treatment, and 97.0% of patients who showed transient or permanent hypothyroidism clustered within 6 months from onset. During follow-up, patients treated with prednisone (PSL) were more likely to have normal thyroid function than patients not treated or those receiving anti-inflammatory drug therapy. In patients who developed hypothyroidism with PSL treatment or without treatment, the rates of bilateral hypoechogenic areas (HEA) were 6-fold higher than those of unilateral HEA. Moreover, permanent hypothyroidism occurred in 5.9% of patients, and all patients with permanent hypothyroidism presented initially with bilateral HEA and had consequently small thyroid size with or without abnormal autoimmunity. Conclusions: The rates of thyroid dysfunction after SAT were significantly lower in patients receiving PSL. Extent of HEA in the thyroid, but not laboratory findings, may be a possible marker for developing thyroid dysfunction after SAT.

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Authors and Affiliations

  1. Center for Excellence in Thyroid Care, Kuma Hospital, Kobe, Japan

    E. Nishihara MD, PhD, N. Amino, H. Ohye, H. Ota, M. Ito, S. Kubota, S. Fukata & A. Miyauchi

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  1. E. Nishihara MD, PhD
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  2. N. Amino
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  3. H. Ohye
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  4. H. Ota
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  5. M. Ito
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  6. S. Kubota
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  7. S. Fukata
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  8. A. Miyauchi
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Correspondence to E. Nishihara MD, PhD.

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Nishihara, E., Amino, N., Ohye, H. et al. Extent of hypoechogenic area in the thyroid is related with thyroid dysfunction after subacute thyroiditis. J Endocrinol Invest 32, 33–36 (2009). https://doi.org/10.1007/BF03345675

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