De Quervain thyroiditis, or subacute granulomatous thyroiditis, is a form of self-limited subacute thyroiditis usually preceded by an upper respiratory tract viral infection such as mumps, measles, coxsackie virus, adenovirus, and influenza viruses.
It usually affects middle age females.
Most patients present with a painful neck along with symptoms and signs of thyrotoxicosis including tachycardia, hot flushes, heat intolerance and palpitations. Subsequently, a short period of hypothyroidism ensues, followed, in the majority of cases, by a return of thyroid function tests back to normal.
The most commonly described sonographic appearance is poorly defined regions of decreased echogenicity with decreased vascularity in the affected areas 1. These can be bilateral or unilateral. The thyroid gland size is mostly normal but can occasionally be enlarged or smaller in size 2.
Low uptake thyroid scan in patients with hyperthyroidism is almost diagnostic, in appropriate clinical setting and ultrasound findings. Correct diagnosis is important as treatment with radioiodine is contraindicated in these patients - it is a self-limited disease.
Treatment and prognosis
It is usually self-limiting 3-4.
History and etymology
Named after Fritz de Quervain, a Swiss surgeon.
- 1. Frates MC, Marqusee E, Benson CB et-al. Subacute granulomatous (de Quervain) thyroiditis: grayscale and color Doppler sonographic characteristics. J Ultrasound Med. 2013;32 (3): 505-11. Pubmed citation
- 2. Park SY, Kim EK, Kim MJ et-al. Ultrasonographic characteristics of subacute granulomatous thyroiditis. Korean J Radiol. 2007;7 (4): 229-34. Free text at pubmed - Pubmed citation
- 3. Zacharia TT, Perumpallichira JJ, Sindhwani V et-al. Gray-scale and color Doppler sonographic findings in a case of subacute granulomatous thyroiditis mimicking thyroid carcinoma. J Clin Ultrasound. 2002;30 (7): 442-4. doi:10.1002/jcu.10087 - Pubmed citation
- 4. Engkakul P, Mahachoklertwattana P, Poomthavorn P. Eponym: de Quervain thyroiditis. Eur. J. Pediatr. 2011;170 (4): 427-31. doi:10.1007/s00431-010-1306-4 - Pubmed citation
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- thyroid nodules
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- postoperative assessment after thyroid cancer surgery
- ultrasound-guided fine needle aspiration of the thyroid