Abstract
CONTEXT: Subacute thyroiditis is an inflammatory thyroid disease, which is treated by nonsteroidal anti-inflammatory drugs (NSAIDs) or steroids. OBJECTIVE: Defining characteristics of patients with subacute thyroiditis at diagnosis and during follow-up. Investigating the efficacies of NSAID and different doses of steroids and their effects on rates of relapse, recurrence, development of hypothyroidism and on quality of life and sleep parameters. DESIGN: A 3-year observational study in a tertiary referral center. SUBJECTS AND METHODS: A total of 63 patients with subacute thyroiditis were included. Clinical outcomes of patients treated with NSAIDs and NSAID unresponsive patients treated with prednisolone with initial doses of 0.5 mg/kg/day and 15 mg/day were evaluated. RESULTS: White blood cell count at diagnosis was an independent predictor of NSAID unresponsiveness. No relapse or recurrence was observed in patients receiving low dose of steroids. Long symptom duration until diagnosis and treatment with NSAIDs were associated with development of hypothyroidism. Subacute thyroiditis caused significant deterioration in quality of life and sleep of patients and low dose of steroid was as effective as higher doses in improving these parameters. CONCLUSIONS: For patients with no response to NSAID therapy, an initial low dose of prednisolone (15 mg/day) is determined as a safe treatment method when dose reduction is performed with appropriate timing.