Antibodies against thyroglobulin, peroxidase or TSH receptor are only transiently elevated or normal. Sudden or gradual onset of pain over the thyroid gland and a high ESR are features, that usually distinguish it from subacute lymphocytic thyroiditis. The initial phase of hyperthyroidism with a diffusely decreased uptake on thyroid scan should be treated with salicylates or steroids. Acute suppurative thyroiditis Acute suppurative thyroiditis is a very rare disorder. Mycobacterial, fungal and other pathogens are usually seen in immunocompromised patients.
Patients have typically severe systemic and local symptoms.
Thyroid scan is usually normal, unless abscess formation has occurred. Thyroid scanning can be helpful in particular situations, i.e. in the differentiation of Grave's disease from subacute lymphocytic or granulomatous thyroiditis in hyperthyroid patients. Radioactive iodine uptake with or without scanning is a good way to monitor thyroid function in patients with subacute granulomatous thyroiditis during treatment. Wang P et al.