ESPE Abstracts

Introduction: Subacute thyroiditis or De Quervain’s Thyroiditis is a self-limited inflammatory thyroid disease that is considered to be caused by a viral infection. Its incidence during the first decade of life is extremely rare. During the acute phase of the disease which lasts 2 to 6 weeks, the inflammatory process results in a temporary release of thyroid hormone with biochemical hyperthyroidism with or without symptoms. This phase is followed by a period with failing hormone production before the thyroid regains his function.

Case report: We describe a case of Thyroiditis De Quervain in a 6 years old girl. She presented with a 10 d history of fever, sore throat, progressive painfull neck swelling and restriction of the neck movement despite treatment with antibiotics over 4 days. Laboratory evaluation revealed high infection parameters and hyperthyroidism. The ultrasound examination of the thyroid gland showed a diffuse inhomogeneous enlargement of the right lobe without evidence of abscess formation. There were no thyroid antibodies detected. The patient was put on NSAID to 5 w. It came to a rapid resolution of symptoms and fever subsided. The thyroid function tests were consistent with euthyreosis within 2 weeks, the ultrasound of the thyroid gland was after 5 weeks completely normal. Virologic studies showed no raised titter against adenovirus or echo virus.

Conclusion: Subacute thyroiditis is reported to be very uncommon in the paediatric population.However it may be underdiagnosed as in that age group viral illnesses are very common. Subacute thyroiditis should be considered in young children as the clinical and ultrasound findings can resemble acute suppurative thyroiditis or thyroid malignoma. Early diagnosis and proper treatment can lead to dramatic improvement of the symptoms and preserve the children from unnecessary diagnostic tests and unnecessary antibiotic treatment. A close follow up in order to monitor the thyroid gland function should be initiated. Nearly all patients show a fully recover.