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Radiation-Induced Thyroiditis
Aka: Radiation-Induced Thyroiditis
- Definition
- Acute Thyroiditis due to neck radiation
- Epidemiology: Incidence
- Occurs in 1% of patients on I-131 for Hyperthyroidism
- Causes
- Radioiodine therapy (I-131) for Hyperthyroidism
- Head and neck radiation for Lymphoma
- High dose irradiation
- Pre-existing Hypothyroidism
- Younger women
- Symptoms
- Anterior Neck Pain or Thyroid pain
- Onset in first 1-2 weeks after I-131 or other neck Radiation Therapy
- Signs
- Thyroid tenderness to palpation
- Thyroid Gland enlargement
- Labs
- Thyroid Function Tests (TSH, T4 Free)
- Hyperthyroidism surges temporarily
- 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)
- Course
- Resolves in 6-18 weeks (typically by 4 weeks) as Thyroid fibrosis occurs
- References
- Bindra (2006) Am Fam Physician 73:1769-76 [PubMed]
- Jereczek (2004) Cancer Treat Rev 30:369-84 [PubMed]
- Quintero (2021) Am Fam Physician 104(6): 609-17 [PubMed]