First examination (first and second row of images):

Clinical presentation: a 33-year-old woman was referred with typical complaints of subacute thyroiditis lasting for 6 weeks.

Palpation: both thyroids were hard and painful.

Functional state: moderate degree of hyperthyroidism with TSH-level 0.001 mIU/L, FT4 27.2 pM/L. Erythrocyte sedimentation rate was 49 mm/H, CRP was 9.2 mg/L.

Ultrasonography: the thyroid was hypoechogenic and inhomogeneous. The vascularization was average.

Cytological diagnosis: subacute, granulomatous de Quervain's thyroiditis.

Suggestion: steroid therapy for 6 weeks. The inflammatory complaints of the patient suddenly stopped within 24 hours of the steroid intake and did not recur after discontinuation of the steroid.

Follow-up examination 4 months after initial investigation (third row of images):

Clinical presentation: the patient had no complaints.

Palpation: no abnormality.

Functional state: subclinical hypothyroidism with TSH-level 4.92 mIU/L, FT4 13.7 pM/L. Erythrocyte sedimentation rate was 11 mm/H, CRP was 0,9 mg/L.

Ultrasonography: the thyroid became smaller and the echo structure had normalized although there were several minimally-moderately hypoechogenic areas in both lobes. There were no significant changes in the vascularization.

Follow-up examination 21 months after initial investigation (fourth row of images):

Clinical presentation: the patient had no complaints.

Palpation: no abnormality.

Functional state: euthyroidism hypothyroidism with TSH-level 1.78 mIU/L.

Ultrasonography: the thyroid became completely echonormal. There were no significant changes in the vascularization.

 

 

 

 

 

 

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