Not Every Sore Throat Is Caused by an Infection!

Among thyroid diseases, subacute thyroiditis, which is not known very much, was a more frequently mentioned problem, especially with the COVID-19 pandemic. Endocrinology and Metabolic Diseases specialist Assoc. Prof. Dr. Özlem Haliloğlu said that patients who have had COVID-19 or another viral upper respiratory tract infection and who hit the ear more prominently on the front of the neck and have flu symptoms such as sore throat, fever-joint pain, especially if the pain is accompanied by complaints such as weight loss, tremor in the hands and palpitations should be investigated.
"Subacute thyroiditis", which is generally defined as inflammation of the thyroid gland following viral upper respiratory tract infections, is shown as the leading cause of painful thyroid gland diseases. Yeditepe University Kozyatağı Hospital Endocrinology and Metabolic Diseases Specialist Assoc. Prof. Dr. Özlem Haliloğlu pointed out the importance of early diagnosis and treatment in terms of both the ease of this painful period and the close follow-up of imbalance in thyroid functions. Assoc. Prof. Dr. Özlem Haliloğlu, who stated that this disease can recur over time in people with subacute thyroiditis, pointed out that permanent hypothyroidism may be seen in up to 10 percent of patients.

Exact Reason is Not Known

According to Assoc. Prof. Dr. Özlem Haliloğlu, the exact cause of subacute thyroiditis is unknown. However, it is thought that a self-limiting inflammation usually develops in the cells of the thyroid gland caused by viral infections. Yeditepe University Kozyatağı Hospital Endocrinology and Metabolic Diseases specialist Assoc. Prof. Dr. Özlem Haliloğlu stated that the emergence of this table in some susceptible people, not in every viral infection survivor, indicates genetic predispositions at the bottom, and said that this result was also revealed by the research conducted.

The Most Important Finding Is Pain With Increased Severity With Swallowing

Stating that painful thyroiditis is more common in young adults and middle ages and its frequency decreases with age, Assoc. Prof. Dr. Özlem Haliloğlu said that the incidence of painful thyroiditis in women is 3.5-4 times higher than in men.
Assoc. Prof. Dr. Özlem Haliloğlu explained that the patients mostly came with complaints of severe pain in their neck, which increased with swallowing on the thyroid gland, and provided the following information about the symptoms:
"When we look at the patients' histories, we see that they usually had a viral upper respiratory infection 2-8 weeks ago. Pain in the neck area begins in one side of the neck and affects the other side within days; it can spread to the upper neck, jaw, and ears. Flu-like symptoms such as fatigue, muscle, and joint pain, and fever are also common with this pain. Signs of thyroid overwork such as weight loss, tremors in the hands, palpitation due to thyroid gland involvement may also be detected in patients."

Symptoms Can Be Confused with Upper Respiratory Tract Infections

The most obvious finding of subacute thyroiditis is neck pain that hits the ear and increases with swallowing, but complaints such as fever, and muscle-joint pain can also be seen, said Assoc. Prof. Dr. Özlem Haliloğlu, added, "Since the findings are similar to upper respiratory tract infections, patients already have this infection in the recent period, they may think that their infections are prolonged and usually receive treatments that do not work in subacute thyroiditis such as antibiotics. This may delay the actual treatment of the patients and, more importantly, may not cause their complaints to regress."

You Need to Rest While on Treatment!

Assoc. Prof. Dr. Özlem Haliloğlu, who stated that they could have to apply to the emergency department due to the severe pain experienced by the patients, gave the following information about the treatment approach: "Patients who have subacute thyroiditis should rest because they cannot do their routine work due to serious symptoms. Therefore, early, and accurate treatment of symptoms is very important. The use of non-steroidal anti-inflammatory drugs ("strong painkillers") together with rest can help relieve complaints. With the right dose of nonsteroidal anti-inflammatory drugs, corticosteroid-containing therapies can be switched to patients who do not have an adequate pain response within a few days. In patients with subacute thyroiditis, the response to corticosteroids is very pronounced, the patient regresses very quickly, and his general condition improves. Short-term palpitations can be used in patients with predominant complaints such as palpitations and hand tremors associated with hyperthyroidism. In addition, some patients may need to use the thyroid hormone during the hypothyroid phase of the disease. Since thyroid hormone imbalances are frequently seen in subacute thyroiditis, close follow-up of patients is necessary."

The Pandemic Caused an Increase in the Number of Cases

While the cases of subacute thyroiditis before the COVID-19 pandemic were more frequently observed in the spring and autumn, Yeditepe University Kozyatağı Hospital Endocrinology and Metabolic Diseases specialist Assoc. Prof. Dr. Özlem Haliloğlu pointed out that there was a very significant increase in the number of subacute thyroiditis patients all over the world without seasonal change with the pandemic, and concluded his words as follows: "In a review published in the literature, in which a large number of new patients were evaluated, it was stated that subacute thyroiditis related to COVID-19 showed similar clinical features to the disease developing outside of COVID-19. Interestingly, it is seen that subacute thyroiditis may 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 pose an obstacle to vaccination."