Should neck pain in a patient with Hashimoto′s thyroiditis be underestimated? A case and review of the literature

Hashimoto′s Thyroiditis (HT) is an autoimmune disease and the most frequent cause of hypothyroidism. Subacute thyroiditis (SAT) overlapping HT is a rare entity. A 69-year-old female patient with HT and multinodular goiter has been followed on levothyroxine replacement therapy for 7 years. She presen...

Full description

Bibliographic Details
Main Authors: Umut Mousa, Anil Cuneyd, Gursoy Alptekin
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2012-01-01
Series:Indian Journal of Endocrinology and Metabolism
Subjects:
Online Access:http://www.ijem.in/article.asp?issn=2230-8210;year=2012;volume=16;issue=3;spage=444;epage=446;aulast=Mousa
_version_ 1819259837698015232
author Umut Mousa
Anil Cuneyd
Gursoy Alptekin
author_facet Umut Mousa
Anil Cuneyd
Gursoy Alptekin
author_sort Umut Mousa
collection DOAJ
description Hashimoto′s Thyroiditis (HT) is an autoimmune disease and the most frequent cause of hypothyroidism. Subacute thyroiditis (SAT) overlapping HT is a rare entity. A 69-year-old female patient with HT and multinodular goiter has been followed on levothyroxine replacement therapy for 7 years. She presented with neck pain radiating to the right ear persisting for 2 months. She was prescribed analgesics and antibiotics by other physicians during that period, which did not work. Her vital signs were stable with no tachycardia or fever. The right lobe of the thyroid gland was tender on palpation. Her TSH level was 3.94 mIU/ml, ESR 23 mm/h, CRP 3.2 mg/l, WBC 4900/μl at presentation. Thyroid ultrasonography revealed a hypoechoic area over the tender lobe. Power Doppler imaging revealed almost no blood flow in that area. She was started on methylprednisolone 32 mg/day. At day 10 of therapy, her symptoms had completely resolved. Ultrasonography repeated showed that the hypoechoic area had disappeared. Glucocorticoid dosage was tapered and stopped. Emergence of subacute thyroiditis in a case with preexisting Hashimoto′s thyroiditis is a quite rare condition, but should be kept in mind along with a painful attack of HT in the differential diagnosis.
first_indexed 2024-12-23T19:16:22Z
format Article
id doaj.art-102f0fab6fc24fd89caa05a1b8a93aca
institution Directory Open Access Journal
issn 2230-8210
2230-9500
language English
last_indexed 2024-12-23T19:16:22Z
publishDate 2012-01-01
publisher Wolters Kluwer Medknow Publications
record_format Article
series Indian Journal of Endocrinology and Metabolism
spelling doaj.art-102f0fab6fc24fd89caa05a1b8a93aca2022-12-21T17:34:18ZengWolters Kluwer Medknow PublicationsIndian Journal of Endocrinology and Metabolism2230-82102230-95002012-01-0116344444610.4103/2230-8210.95709Should neck pain in a patient with Hashimoto′s thyroiditis be underestimated? A case and review of the literatureUmut MousaAnil CuneydGursoy AlptekinHashimoto′s Thyroiditis (HT) is an autoimmune disease and the most frequent cause of hypothyroidism. Subacute thyroiditis (SAT) overlapping HT is a rare entity. A 69-year-old female patient with HT and multinodular goiter has been followed on levothyroxine replacement therapy for 7 years. She presented with neck pain radiating to the right ear persisting for 2 months. She was prescribed analgesics and antibiotics by other physicians during that period, which did not work. Her vital signs were stable with no tachycardia or fever. The right lobe of the thyroid gland was tender on palpation. Her TSH level was 3.94 mIU/ml, ESR 23 mm/h, CRP 3.2 mg/l, WBC 4900/μl at presentation. Thyroid ultrasonography revealed a hypoechoic area over the tender lobe. Power Doppler imaging revealed almost no blood flow in that area. She was started on methylprednisolone 32 mg/day. At day 10 of therapy, her symptoms had completely resolved. Ultrasonography repeated showed that the hypoechoic area had disappeared. Glucocorticoid dosage was tapered and stopped. Emergence of subacute thyroiditis in a case with preexisting Hashimoto′s thyroiditis is a quite rare condition, but should be kept in mind along with a painful attack of HT in the differential diagnosis.http://www.ijem.in/article.asp?issn=2230-8210;year=2012;volume=16;issue=3;spage=444;epage=446;aulast=MousaAcute exacerbationde Quervain′sHashimoto′s thyroiditispainfulsubacute thyroiditis
spellingShingle Umut Mousa
Anil Cuneyd
Gursoy Alptekin
Should neck pain in a patient with Hashimoto′s thyroiditis be underestimated? A case and review of the literature
Indian Journal of Endocrinology and Metabolism
Acute exacerbation
de Quervain′s
Hashimoto′s thyroiditis
painful
subacute thyroiditis
title Should neck pain in a patient with Hashimoto′s thyroiditis be underestimated? A case and review of the literature
title_full Should neck pain in a patient with Hashimoto′s thyroiditis be underestimated? A case and review of the literature
title_fullStr Should neck pain in a patient with Hashimoto′s thyroiditis be underestimated? A case and review of the literature
title_full_unstemmed Should neck pain in a patient with Hashimoto′s thyroiditis be underestimated? A case and review of the literature
title_short Should neck pain in a patient with Hashimoto′s thyroiditis be underestimated? A case and review of the literature
title_sort should neck pain in a patient with hashimoto s thyroiditis be underestimated a case and review of the literature
topic Acute exacerbation
de Quervain′s
Hashimoto′s thyroiditis
painful
subacute thyroiditis
url http://www.ijem.in/article.asp?issn=2230-8210;year=2012;volume=16;issue=3;spage=444;epage=446;aulast=Mousa
work_keys_str_mv AT umutmousa shouldneckpaininapatientwithhashimotosthyroiditisbeunderestimatedacaseandreviewoftheliterature
AT anilcuneyd shouldneckpaininapatientwithhashimotosthyroiditisbeunderestimatedacaseandreviewoftheliterature
AT gursoyalptekin shouldneckpaininapatientwithhashimotosthyroiditisbeunderestimatedacaseandreviewoftheliterature