Which of the following is consistent with diagnosis of De-Quervain thyroiditis?

A. 45 year female with 2 week history of painful thyroid gland with elevated T4, T3 and low TSH. RAIU shows increased uptake

B. 25 year female with painless enlarged thyroid with elevated T4,T3 and undetectable TSH. RAIU shows increased uptake

C. 45 year female with fatigue and low T4, T3 and Low TSH

D. 45 year male with painful thyroid 8 weeks ago with low free T4, T3 and elevated TSH

Correct Answer: 45 year male with painful thyroid 8 weeks ago with low free T4, T3 and elevated TSH

Description: De Quervain thyroiditis is characterised by fever, constitutional symptoms and painful enlarged thyroid due to viral etiology. Initially T4 and T3 are elevated due to damage to follicles. RAIU uptake is reduced. Subsequently hypothyroid phase sets in and RAIU becomes normal. Option A is wrong due to increased RAIU uptake which is never possible in viral thyroiditis. Option B is consistent with Grave's disease with increased RAIU. Option C indicates Central hypothyroidism. Option D indicates late phase of De Quervain thyroiditis.

Category: Medicine

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