It is thought that sore throats are caused by foods that are eaten or drunk with hot or water. But heat, cold, or throat infections aren’t the only causes of sore throats. Subacute thyroiditis, one of the thyroid diseases, can also cause sore throat. In this context, Assoc. Dr. Özlem Haliloğlu said that patients who have had Covid-19 or another viral upper respiratory tract infection and who have flu symptoms such as sore throat, fever-joint pains, which hit the ear prominently on the front of the neck and increase with swallowing, should be investigated.
EARLY DIAGNOSIS AND TREATMENT IS IMPORTANT
‘Subacute thyroiditis’, which is defined as thyroid gland inflammation that usually occurs following viral upper respiratory tract infections, is shown as the leading cause of painful thyroid gland diseases. Endocrinology and Metabolic Diseases specialist Assoc. Dr. Özlem Haliloğlu pointed out the importance of early diagnosis and treatment for this condition in terms of both ease of this painful period and close follow-up of the imbalance in thyroid functions. Stating that this disease can recur over time in people with subacute thyroiditis, Assoc. Dr. Özlem Haliloğlu pointed out that up to 10 percent of patients can have permanent hypothyroidism.
EXACT CAUSE IS UNKNOWN
Emphasizing that the exact cause of subacute thyroiditis is unknown, Assoc. Dr. Özlem Haliloğlu stated that it is also thought that a self-limiting inflammation caused by viral infections in the cells of the thyroid gland develops. Assoc. Dr. Özlem Haliloğlu said that this result was also demonstrated by the researches.
FREQUENCY DECREASES WITH AGE
Stating that painful thyroiditis is more common in young adults and middle ages, its frequency decreases with age, Assoc. Dr. Özlem Haliloğlu explained that the incidence in women is 3.5-4 times higher than in men. Explaining that the patients mostly complain of severe pain in the neck, on the thyroid gland, which increases with swallowing, Assoc. Dr. Özlem Haliloğlu gave the following information about the symptoms:
“When we look at the histories of the patients, we usually see that they had a viral upper respiratory tract infection 2-8 weeks ago. The pain in the neck area starts from one side of the neck and affects the other side within days; may spread to the upper neck, chin, and ears. Along with this pain, flu-like symptoms such as fatigue, muscle and joint aches, and fever are also common. Patients may also have signs of overworking the thyroid, such as weight loss, tremors in the hands, and palpitations due to the thyroid gland being affected.
NECK PAIN WHERE THE MOST CLEAR FINDING IS
Assoc. Dr. Özlem Haliloğlu said, “Since the findings are similar to upper respiratory tract infections, patients may think that their infections are prolonged because they have already had this infection in the recent period, and they usually receive treatments that do not work in subacute thyroiditis, such as antibiotics. This can lead to delays in the actual treatment of patients and, more importantly, that their complaints do not regress.
“CLOSE FOLLOW-UP OF PATIENTS IS REQUIRED”
Stating that patients may have to apply to the emergency service due to severe pain, Assoc. Dr. Özlem Haliloğlu, on her treatment approach, said, “Patients with subacute thyroiditis need to rest because they cannot do their routine work due to serious symptoms. Therefore, early and correct treatment of symptoms is very important. The use of non-steroidal anti-inflammatory drugs (strong painkillers) together with rest relieves the complaints. In patients who do not get adequate pain response with the right dose of non-steroidal anti-inflammatory drugs within a few days, they can be switched to corticosteroid-containing treatments. Response to corticosteroids is very evident in patients with subacute thyroiditis, the patient’s pain regresses very quickly, and his general condition improves. Short-term anti-palpitation drugs can be used in patients with predominant complaints such as palpitation and hand tremor associated with hyperthyroidism. In addition, some patients may need to use thyroid hormone in the hypothyroid phase of the disease. Since thyroid hormone imbalances are frequently seen in subacute thyroiditis, close follow-up of patients is required.
CASES HAVE INCREASED DUE TO THE PANDEMIC
Pointing out that while he observed subacute thyroiditis cases more frequently in the spring and autumn before the Covid-19 pandemic, there was a very serious increase in the number of subacute thyroiditis patients all over the world, without seasonal variation, with the pandemic, Assoc. Dr. Haliloğlu, “In a review published in the literature and evaluating many new patients; It has been stated that Covid-19-associated subacute thyroiditis has clinical features similar to non-Covid disease. Interestingly, it is seen that subacute thyroiditis can develop not only in those who have had Covid-19, but also after the Covid-19 vaccine. Vaccine-associated subacute thyroiditis can be seen within a few hours to a few weeks after vaccination, and its clinic is milder, so it does not constitute an obstacle to being vaccinated.