Subacute thyroiditis develops as a result of viral infections and/or postviral inflammatory responses. Severe pain and tenderness are present in the
thyroid gland. The subacute thyroiditis treatment recommendation is mostly based on clinical experience. we aimed to present a new approach (ECE
protocol) in patients who did not recur in follow-up for at least 6months after treatment.
Keywords: Subacute thyroiditis; New approach; Treatment
Subacute thyroiditis is the most common cause of painful
thyroid gland disease. The disease was first described by Fritz De
Quervain in 1904. It is a self-limiting disease that usually occurs
after viral upper respiratory tract infection. In the pathophysiology
(Table 1), the apoptosis of the follicular epithelium and the
deterioration of the follicle integrity are essential. The disease rate
increases in young adults and decreases in later ages. Subacute
thyroiditis is 3.5-4 times more common in females than males.
It is most commonly seen in August and September [1-6]. The
subacute thyroiditis treatment recommendation is mostly based on
clinical experience. In this presentation, we aimed to present a new
approach in patients who did not recur in follow-up for at least 6
months after treatment .
Table 1: Subacute thyroiditis treatment with ECE protocol.
Check after 3 months if complete recovery is achieved. The patient should be informed about
If there is improvement in the laboratory but the subacute trioid is continuing clinically and
radiologically; monthly control with methylprednisolone 4mg x 1 maintenance treatment.
If the clinical improvement is not achieved after methylprednisolone within 3 days of treatment, the
patient should be reevaluated for differential diagnosis.
Metformin can be initiated with impaired fasting glucose and impaired glucose tolerance in patients
with dietary and lifestyle changes [5-6].
In patients with dyspeptic complaints, the proton pump inhibitor should be started with the treatment.
Iodine-restricted diet in dietician partnership.
Beta-blocker therapy may be given temporarily in patients with early onset tachycardia.
Professor, Chief Doctor, Director of Department of Pediatric Surgery, Associate Director of Department of Surgery, Doctoral Supervisor Tongji hospital, Tongji medical college, Huazhong University of Science and Technology