ketendoКлиническая и экспериментальная тиреоидологияClinical and experimental thyroidology1995-54722310-3787Endocrinology Research Centre10.14341/ket12728ketendo-12728Research ArticleОригинальные исследованияOriginal StudiesПодострый тиреоидит и его клинические ­характеристики — ретроспективное одноцентровое клиническое исследованиеSubacute thyroiditis and its clinical characteristics — a retrospective single center clinical studyМаневскаН.ManevskaN.

Невена Маневска - медицинский факультет.

Скопье

Nevena Manevska - nuclear medicine specialist, Ass. Prof.

dr.nmanevska@gmail.comhttps://orcid.org/0000-0003-1844-6839БожиновскаН.BozinovskaN.

Николина Божиновска - медицинский факультет.

Скопье

Nikolina Bozinovska - nuclear medicine specialist, Ass. Dr. Faculty of Medicine.

Skopje

n.bozinovska@hotmail.comhttps://orcid.org/0000-0001-7011-3949Стойловска РизоваБ.Stoilovska RizovaB.

Бояна Стойловска Ризова - медицинский факультет.

Скопье

Bojana Stoilovska Rizova - nuclear medicine specialist, Ass. Dr. Faculty of Medicine.

Skopje

bstoilovska@gmail.comhttps://orcid.org/0000-0002-4967-2102СтояноскиС.StojanoskiS.

Синиса Стояноски - медицинский факультет.

Скопье

Sinisa Stojanoski - nuclear medicine specialist, Ass. Prof. Faculty of Medicine.

Skopje

sinisa.stojanoski@hotmail.comhttps://orcid.org/0000-0003-0460-2116МаказлиеваТ.MakazlievaT.

Таня Маказлиева - медицинский факультет.

Скопье

Tanja Makazlieva - nuclear medicine specialist, Ass. Prof. Faculty of Medicine.

Skopje

tmakazlieva@gmail.comИнститут патофизиологии и ядерной медицины, Университета св. Кирилла и МефодияМакедонияInstitute of Pathophysiology and Nuclear medicine, University of Ss. Cyril and MethodiusMacedonia, the former Yugoslav Republic of2022241220221822731Copyright © Маневска Н., Божиновска Н., Стойловска Ризова Б., Стояноски С., Маказлиева Т., 20222022Маневска Н., Божиновска Н., Стойловска Ризова Б., Стояноски С., Маказлиева Т.Manevska N., Bozinovska N., Stoilovska Rizova B., Stojanoski S., Makazlieva T.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.cet-endojournals.ru/jour/article/view/12728ВВЕДЕНИЕ

ВВЕДЕНИЕ: Типичными признаками подострого тиреоидита являются такие признаки, как боль в шее, высокая температура тела, нарушения функции щитовидной железы (ЩЖ), повышение воспалительных маркеров и гипоэхогенные характеристики по данным УЗИ ЩЖ. Для лечения применяются нестероидные противовоспалительные средства и глюкокортикостероидные препараты.

ЦЕЛЬ

ЦЕЛЬ: Изучить клиническую характеристику пациентов с подострым тиреоидитом путем определения уровня тиреоидных гормонов, размеров и структуры ЩЖ по данным УЗИ и сцинтиграфии.

МАТЕРИАЛЫ И МЕТОДЫ

МАТЕРИАЛЫ И МЕТОДЫ: Проведен ретроспективный анализ 122 случаев подострого тиреоидита (пациенты обоих полов, средний возраст 45,05±12,18 года) за период 2015–2020 гг. Оценивались ежемесячная частота возникновения подострого тиреоидита, клиническое состояние пациентов, включая симптомы тиреотоксикоза, температуру тела, лабораторные показатели: Т4 св. и ТТГ, уровень С-РБ и СОЭ, данные УЗИ и сцинтиграфии.

РЕЗУЛЬТАТЫ

РЕЗУЛЬТАТЫ: Большинство пациентов предъявляли жалобы на боли в шее, повышенная температура тела отмечалась у 66/100 (66%) пациентов. Диагноз подострого тиреоидита обычно устанавливали в тиреотоксической фазе. По данным УЗИ ЩЖ чаще всего выявлялось увеличение размеров ЩЖ, в то время как у 52 пациентов ЩЖ была нормального размера с преимущественно гипоэхогенной негомогенной структурой. На сцинтиграммах определялось отсутствие визуализации ЩЖ у 72/98 (73,47%) пациентов и снижение захвата РФЛП в обеих долях у 26/98 (26,53%).

ЗАКЛЮЧЕНИЕ

ЗАКЛЮЧЕНИЕ: Необходимо повысить осведомленность врачей о пациентах с болью в шее для верной постановки диагноза подострого тиреоидита, который часто диагностируют много позже, что приводит к ошибочному чрезмерному использованию антибиотиков. Как правило, нестероидные противовоспалительные препараты эффективны для уменьшения болей в ЩЖ у пациентов с легкими формами заболевания.

INTRODUCTION

INTRODUCTION. Typical clinical features of subacute thyroiditis (SAT) are commonly assessed such as – neck pain and high body temperature, as well as thyroid function abnormalities, elevated inflammatory markers, and strongly suggestive hypoechoic ultrasonography characteristics. Non-steroid anti-inflammatory agents and corticosteroids are used.

AIM

AIM. To examine the clinical characteristics in patients with SAT, by determining the level of thyroid hormones, the size and structure of the thyroid gland as well as ultrasound and scintigraphy findings.

MATERIALS AND METHODS

MATERIALS AND METHODS. We performed retrospective analysis in 122 cases of SAT (both genders, mean age 45.05±12,18 years), in the period 2015-2020. We evaluated monthly frequency of the SAT occurrence, the clinical status of the patients including symptoms, body temperature, laboratory results of FT4 and TSH, CRP and ESR level, ultrasonography and scintigraphy findings.

RESULTS

RESULTS. Most of the patients complained of neck pain, high body temperature was detected in 66/100 (66%) pts. CRP and ESR Patients were usually diagnosed in hyperthyroid phase of the disease. Enlarged thyroid gland was mostly seen on US, while 52 had normal thyroid gland, with predominantly hypoechoic non-chomogenous structure. Scintigraphy noted “empty” scan (without presentation of functional thyroid tissue) in 72/98 (73,47%) and hypofixation mainly in both lobes in 26/98 (26,53%) pts.

CONCLUSION

CONCLUSION. The awareness of physicians needs to be increased in patients with neck pain for proper diagnosis of SAT, that is often is often misdiagnosed or delayed, leading to erroneous antibiotic overuse. Generally, nonsteroidal anti-inflammatory drugs are effective in reducing thyroid pain in patients with mild cases.

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The authors declare that there are no conflicts of interest present.