Evaluation of recurrence in 36 subacute thyroiditis patients managed with prednisolone.
OBJECTIVE
The incidence of subacute thyroiditis (SAT) is low and there are a few reports of recurrence of subacute thyroiditis. Current treatment protocols for SAT are not uniform. Prednisolone (PSL) is chosen more often for treatment than nonsteroidal anti-inflammatory drugs. This study was undertaken to confirm the recurrence rate of SAT managed by PSL, and to compare the initial laboratory data between the recurrent and the non-recurrent groups.


METHODS
After diagnosis, all patients were treated with PSL (starting at 30 mg or 25 mg per day, tapered by 5 mg per week) for 5 or 6 weeks. We evaluated data and symptoms at the first visit and during the therapy.


METHODS
Thirty-six patients who received only PSL for SAT at our hospital between January 1997 and December 1998 were referred. These patients asked to visit every 2 weeks for the monitoring of symptoms and laboratory data.


RESULTS
SAT symptoms recurred in eight patients (22%), most upon cessation of PSL. There was no difference in initial serum sialic acid, erythrocyte sedimentation rate, C-reactive protein, thyroglobulin, serum free thyroxine and free triiodothyronine before PSL treatment between the recurrent and non-recurrent patient populations.


CONCLUSIONS
The recurrence rate of SAT with treated PSL is about 20%. There was no difference in the laboratory data before starting the therapy between recurrent and non-recurrent groups. Therefore, a modified protocol of PSL administration may be needed to decrease the early recurrent rate of SAT.
Mizukoshi
T
T
Noguchi Thyroid Clinic and Hospital Foundation, Beppu.
Noguchi
S
S
Murakami
T
T
Futata
T
T
Yamashita
H
H
D000328:Adult; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007564:Japan; D008297:Male; D008875:Middle Aged; D019158:N-Acetylneuraminic Acid / Q000097:blood; D011239:Prednisolone / Q000627:therapeutic use*; D012008:Recurrence; D013954:Thyroglobulin / Q000097:blood; D013968:Thyroiditis, Subacute / Q000188:drug therapy* / Q000453:epidemiology / Q000503:physiopathology*; D013974:Thyroxine / Q000097:blood; D014284:Triiodothyronine / Q000097:blood
D000893:Anti-Inflammatory Agents; D015415:Biomarkers; D014284:Triiodothyronine; D002097:C-Reactive Protein; D013954:Thyroglobulin; D011239:Prednisolone; D019158:N-Acetylneuraminic Acid; D013974:Thyroxine