De Kervina's thyroiditis is an inflammatory thyroid disease. The etiology is supposedly viral; it has been studied poorly. Perhaps the course of subacute, acute, chronic, recurrent. The most common cases of the disease in the age range of 20 to 50 years, in women it occurs much more often. For every 20 fixed cases of thyroiditis, only one subacute thyroiditis occurs. It is he who will be considered in the article.
Subacute thyroiditis. Development reasons
Passes against a background of viral diseases, or after them. According to studies, the disease most often occurs after infection with the Coxsackie virus, adenovirus, mumps, and influenza viruses.
Thyroiditis. Symptoms
The onset may be acute: fever; neck pain (when swallowing intensifies, surrendering in the ear); pain in the lower jaw; weakness and general malaise.
However, more often a gradual onset has begun: the malaise is slight, discomfort in the thyroid gland, a slight discomfort when swallowing. When you try to tilt or turn your head, pain occurs. Pain can also occur when chewing. The proportion of the thyroid gland increases and is painful when palpated. Lymph nodes, as a rule, are unchanged (do not increase). From the eyes, skin, heart, there are no symptoms. Patient complaints are directed mainly to sweating, insomnia, joint pain. With the disease, the production of thyrotropin, a hormone that stimulates the thyroid gland, decreases. The disease can last up to six months.
Subacute thyroiditis. Treatment
Medical treatment of subacute thyroiditis. Synthetic glucocorticoid hormones (dexamethasone, prednisone, metipred, kenacort) are mainly used. When the condition begins to normalize, the dose of hormones gradually decreases.
At the initial stage, the treatment is symptomatic. Aspirin is prescribed (for mild pain 600 mg every 3.5 hours), or prednisone (10-20 mg twice a day). The pain decreases after the first dose. If the effect of pain relief does not occur, the diagnosis is called into question. After a week of taking the drug, the dose is reduced every 5 days by 5 mg. The duration of treatment is prescribed by the doctor. In any case, it should not be more than a month. If after discontinuation of the drug the pain intensifies again, the dose is increased and reduced again. To eliminate the symptoms of thyrotoxicosis, propranolol (up to 40 mg, up to four times a day) can be prescribed. In this case , antithyroid drugs are not used.
Subacute thyroiditis in the hypothyroid stage usually lasts no more than three months. Replacement therapy is indicated (levothyroxine, 0.10 mg, enough once a day).
The use of hormonal drugs should not exceed two months. The mild course of the disease allows you to confine yourself to the use in the treatment of brufen (or voltaren), indomethacin and aspirin. Severe thyrotoxicosis is possible. In this case, beta-blockers should be prescribed. For the treatment of subacute thyroiditis, antibiotics are not prescribed. Moreover, they are contraindicated, since they can lead to a worsening of the patient's condition.
The forecast is good. The disease is easily treatable. In addition, if treatment is started in a timely manner, after three months (or even earlier), a full recovery occurs. However, if this disease is ignored and treatment is abandoned, it will last quite a long time (up to two years) and may well develop into another, chronic, form with complications.
Complications
The formation in the thyroid gland of an abscess capable of breaking through. In case of ingestion, it flows into the pericardial space; possible damage to blood vessels; introduction of infection to brain tissue; the development of sepsis.