II. Definition
- Acute Thyroiditis due to neck radiation
III. Epidemiology: Incidence
- Occurs in 1% of patients on I-131 for Hyperthyroidism
IV. Causes
- Radioiodine therapy (I-131) for Hyperthyroidism
- Head and neck radiation for Lymphoma
- High dose irradiation
- Pre-existing Hypothyroidism
- Younger women
V. Symptoms
- Anterior Neck Pain or Thyroid pain
- Onset in first 1-2 weeks after I-131 or other neck Radiation Therapy
VI. Signs
- Thyroid tenderness to palpation
- Thyroid Gland enlargement
VII. Labs
-
Thyroid Function Tests (TSH, T4 Free)
- Hyperthyroidism surges temporarily
VIII. Management
-
Thyroid Pain
- NSAIDs
- Prednisone if refractory to NSAIDs (rarely needed)
- Short course at 40-60 mg orally daily with taper
-
Hyperthyroidism symptoms
- Beta Blocker (e.g. Propranolol)
IX. Course
- Resolves in 6-18 weeks (typically by 4 weeks) as Thyroid fibrosis occurs
