Advances In Diagnosis And Treatment Of Subacute Thyroiditis

Background:Subacute thyroiditis(SAT)was first described by De Quervain in 1940,also known as De Quervain thyroiditis,giant cell thyroiditis and granulomatous thyroiditis.It is a non-bacterial infectious diseases which can be self-recovery.The clinical incidence rate is about 4.9/100,000.It is a common and frequently occurring disease of thyroid disease.It is also the most common cause of thyroid pain witch thought to be associated with viral infection or genetic predisposition.The patients are mostly women aged from 20 to 50.Most of the patients with SAT are diagnosed according to their typical clinical manifestations,laboratory tests,131 iodine uptake rate,imaging examination and thyroid cytology.Because of the atypical symptoms of some patients,it is easy to be misdiagnosed.So we need to distinguish it from other thyroid diseases.In order to cure it,we commonly use non steroidal anti-inflammatory drugs or corticosteroids clinically.But SAT has a long duration and it’s easy to relapse,so hormone therapy often lacks of quantitative standards for determining the efficacy.In clinical practice,it is found that the usual methods,such as reduction and drug withdrawal,often lead to relapse.Objective:By summing up the current study on diagnosis and treatment of subacute thyroiditis,we hope to provide some reference for reducing the rate of misdiagnosis and the effective treatment of subacute thyroiditis.Methods:Searching the MEDLIN,PubMed,OVID,APS Journals,Engineering Village,ScienceDirectJournal,SpringerLink,Elsevier CNKI,vip database,WanFang,CBM disc with the key words " SAT","diagnosis","differential diagnosis",and "treatment" from 1990-2016,I got 122 articles about the development of the treatment of SAT.90 articles are left after removing the duplication.After the initial screening,there are 77 articles left.Removing 5 articles about SAT combined with Graves’ s disease and 8articles about HT associated with SAT,there are 64 articles left.Analysis the remaining 64 articles,find out the relevant study about the diagnosis and treatment of SAT.Results and conclusions:At present,there are a great deal of documents about the diagnosis and treatment of SAT.Referring to these findings,we can master the diagnosis and differential diagnosis of SATmore accurately.Although glucocorticoids are the first choice for the treatment of acute phase SAT in the clinical treatment currently,there is no definite standard for the initial dosage,the basis of the dose reduction,the time for withdrawal and the total course of treatment.Therefore,the safety and effectiveness of glucocorticoids in the treatment of SAT and the appropriate time for reduction and withdrawal still need to be confirmed by prospective randomized controlled study with a large sample.