ĐẶC ĐIỂM LÂM SÀNG, CẬN LÂM SÀNG CỦA NGƯỜI BỆNH VIÊM TUYẾN GIÁP BÁN CẤP

Abstract

Background: Subacute thyroiditis (De Quervain) is a condition with atypical clinical manifestations that are easily mistaken for pharyngeal infections, often leading to delayed diagnosis and inappropriate treatment. Objectives: To describe the clinical and laboratory characteristics of subacute thyroiditis. Objects and methods: A cross-sectional study of  patients diagnosed with sub-acute thyroiditis based on presence of painful swelling of the thyroid gland, increased plasma CRP and blood sedimentation rate, decreased plasma TSH and increased plasma FT4 levels, decreased thyroid ultrasound echo density. Results: Among 50 patients with subacute thyroiditis, the mean age was 44.6 ± 9.2 years, with a predominance of females (79.7%, female-to-male ratio = 3.9:1). Forty-four percent had been examined prior to admission, most of whom were misdiagnosed with pharyngeal infections. Neck pain localized to the thyroid was the most common symptom (100%), mainly unilateral (82%), aggravated by swallowing (82%), and radiating in some cases (56%); approximately 34% reported a history of preceding viral illness. Regarding laboratory findings, 78% of patients presented with thyrotoxicosis (44% overt, 34% subclinical). C-reactive protein was elevated in 86%, and erythrocyte sedimentation rate was increased in 100% of cases. Thyroid ultrasound revealed heterogeneous hypoechogenicity in all patients, predominantly involving a single lobe. Conclusions: Thyroid pain, accelerated erythrocyte sedimentation rate and reduced thyroid ultrasound echo density was present in all the patients with subacute thyroiditis. Nearly three quarters of the patients were in thyrotoxicosis phase. Elevated serum CRP was present in almost all the patients