Abstract

MALTA, Joana; MATOS, Ana Catarina; MALTA, Daniela  and  PORTUGAL, Jorge. Subacute thyroiditis, an uncommon cause of odynophagia: case report. Rev Port Med Geral Fam [online]. 2019, vol.35, n.2, pp.147-150. ISSN 2182-5173.  https://doi.org/10.32385/rpmgf.v35i2.11927.

Introduction: Subacute thyroiditis, or De Quervain's thyroiditis, is an uncommon condition. It can manifest itself as an anterior neck pain with radiation into the oropharynx, leading to odynophagia, a very common symptom in primary care. This case report demonstrates the importance of being aware of this clinical entity as a differential diagnosis of odynophagia, particularly when in presence of symptoms and signs of thyrotoxicosis. Case description: 36-years old female, presenting with fever, odynophagia sore throat and swollen neck, initially treated as an upper respiratory tract infection. Since no clinical improvement was observed, the patient was re-assessed and clinical signs of thyroid pathology were identified. The diagnosis of subacute thyroiditis was based on biochemical markers of inflammation and thyrotoxicosis, as well as on the exclusion of autoimmune and bacterial causes. The treatment plan included symptomatic control with anti-inflammatory drugs, with improvement of symptoms over the following weeks. Subsequently, the patient developed an hypothyroidism and was treated with levothyroxine therapy. Comment: The early diagnosis of subacute thyroiditis may not be easy due its initial presentation, and may suggest a common pharyngitis. Although being an uncommon diagnosis, this diagnosis should be considered when in presence of odynophagia / neck pain and fever and other symptoms/signs should be searched, in order to minimise patient discomfort and healthcare resources' spending.

Keywords : Thyroiditis subacute; Sore throat; Thyrotoxicosis; Odynophagia.

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