SUBACUTE GRANULOMATOUS THYROIDITIS – A CLINICAL CASE

1.Background & Aim Subacute granulomatous thyroiditis is an uncommon disease that most often occurs in middle-aged women. A painful thyroid following an upper respiratory tract infection is often a sign of this disease. When a 34-years-old man presents with enlarged thyroid and changed laboratory data, subacute granulomatous thyroiditis is not the first suspicion. 2. Method Patient observed in Castro Marim health center, in Primary Health Care. Clinical data were collected from personal clinical file with patient consent 3. Results 35-years-old man, previously healthy, presents in the consultation with asthenia, palpitations and low fever (38ºC) over 2 months. Refers thyroid enlargement with occasional dysphagia, after episode of acute tonsillitis treated with antibiotic. Laboratory data showed supressed levels of thyroid stimulating hormone (TSH) and elevated thyroxine (T4). Ultrasonography reported gland enlargement to approximately twice its normal size, with multiple nodules. We called a colleague Endocrinologist in Hospital de Faro that recommend new laboratory data and an aspiration biopsy. Patient started ibuprofen 400mg 8-8h. Serial analysis showed a TSH and T4 fluctuation and aspiration biopsy revealed undetermined significance injury; sample with moderate cellularity, scarce colloid and follicular cell aggregates unchanged. After 6 months follow-up, this patient has no symptoms and presents normal thyroid function. He has been followed in Endocrinology with regular laboratory and ultrasonography evaluation. 4. Conclusions Subacute granulomatous thyroiditis is a self-limited disease that often resolves spontaneously, usually without subsequent thyroid function abnormalities.