Discussion Inflammatory thyroid diseases account for about half of all clinical thyroid disorders. The highest incidence occurs in middle aged women, who usually present with a non-tender goiter and who are biochemically either euthyroid or hypothyroid. A thyroid scan provides only limited additional information. It usually shows patchy uptake and occasionally hot or hot and cold nodules. Thyroid peroxidase antibodies can nearly always be found.
Patients initially present with hyperthyroidism and a painless goiter.
In the acute phase there is minimal or absent uptake of Pertechnetate or Iodine in the gland, which allows differentiation from Grave's disease. After a variable period of weeks to months the patients become briefly euthyroid and than hypothyroid. It is more common in females with a peak incidence between 30 and 50. 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.