Atypical Subacute Thyroiditis without Thyroid Dysfunction: A Report of Two Cases.
Yuji Nagayama, Seigo Tachibana, Takashi Fukuda et al.
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Case in brief
Two patients presented with anterior neck pain and tender thyroid nodules, with elevated inflammatory markers and ultrasound findings characteristic of subacute thyroiditis (SAT). Despite this clinical and imaging pattern, both remained euthyroid throughout their courses. Serum thyroglobulin was elevated in one case. The authors considered the presentations consistent with SAT, although neither met the Japan Thyroid Association’s current diagnostic criteria. The report highlights that SAT can present without the usual thyroid-function changes of transient thyrotoxicosis followed by hypothyroidism.
What made this case unusual
Both patients had a clinical and ultrasound picture suggestive of SAT but remained euthyroid, an atypical presentation that did not meet current Japan Thyroid Association diagnostic criteria.
Diagnostic / clinical pearl
Normal thyroid function tests do not exclude SAT when neck pain, tender nodules, inflammatory markers, and characteristic ultrasound findings support the diagnosis.