KẾT QUẢ ĐIỀU TRỊ VIÊM TUYẾN GIÁP BÁN CẤP TẠI BỆNH VIỆN NỘI TIẾT TRUNG ƯƠNG

Abstract

Objectives: To describe the treatment of subacute thyroiditis and its results in The National Hospital of Endocrinology. Subjects and methods: An observational study was performed in patients diagnosed with and treated for subacute thyroiditis, and followed up for up to 3 weeks after drug discontinuation. Results: 37 patients with subacute thyroiditis were included in the study; most were women (81.1%), aged from 26 to 71 years. All the patients received a single glucocorticoid that was methylprednisolone. Its initial dose ranged from 8 to 32mg/day and from 16mg/day or more in 89.2% of the patients, and was reduced by 4mg/week. The treatment duration ranged from 10 to 42 days and from 28 days or more in 86.5% of the patients. The disease remission at the treatment end was 70.3% and its relapse during and after the treatment for up to 3 weeks after drug discontinuation was 21.6%. Compared to the patients without the disease relapse those with the relapse had lower initial and total dose of methylprednisolone. Compared to the patients receiving an initial methylprednisolone dose of 20mg/day or less, those receiving that of 24mg/day or more had a longer treatment duration, a higher disease remission rate (92.9% vs. 56.5%, p = 0.020) and a lower disease relapse rate (7.1% vs. 30.4%, p = 0.102). Conclusions: All the patients received methylprenisolon for treatment of subacute thyroiditis. The majority of the patients had the disease remission but one considerable proportion of patients  relapsed during the drug dose reduction or for up to 3 weeks after the drug discontinuation. Higher glucocorticoid doses could attain higher disease remission rate and lower disease relapse rate compared to lower doses.