title: Time-lag between symptom onset and laboratory findings in patients with subacute thyroiditis.
abstract: OBJECTIVE
  The objective of this study was to delineate the frequency of delayed diagnosis in cases of subacute thyroiditis (SAT) and intervals between onset of clinical symptoms and appearance of abnormal laboratory findings.
  
  
  METHODS
  We reviewed the medical records of 27 patients (7 men and 20 women) with SAT who visited our hospital between 2007 and 2013.
  
  
  RESULTS
  On presentation to the hospital, 5 of 27 SAT cases (18.5%) showed normal laboratory findings. Among these 5 cases, the mean interval between symptom onset and thyrotropin (TSH) suppression was 6.3 weeks, and the mean interval to elevation of fT4 was 6.7 weeks. The longest interval from symptom onset to appearance of an abnormal laboratory finding was 11 weeks.
  
  
  CONCLUSIONS
  Sometimes time-lag exists between onset of clinical symptoms and the appearance of abnormal laboratory findings in patients with SAT. The possibility of this disease should not be excluded from the differential diagnoses for patients with clinical symptoms consistent with SAT but showing normal laboratory findings.
authors.affiliation: Department of Otolaryngology, Himeji Red Cross Hospital, 12-1 Shimoteno 1-Chome, Himeji City, Hyogo 670-8540, Japan. Electronic address: tomoyasutachibana@hotmail.co.jp.
authors.forename: Tomoyasu
authors.initials: T
authors.lastname: Tachibana
authors.affiliation: Department of Otolaryngology Head and Neck Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama City, Okayama 700-8558, Japan.
authors.forename: Yorihisa
authors.initials: Y
authors.lastname: Orita
authors.affiliation: Department of Otolaryngology, Himeji Red Cross Hospital, 12-1 Shimoteno 1-Chome, Himeji City, Hyogo 670-8540, Japan.
authors.forename: Yuya
authors.initials: Y
authors.lastname: Ogawara
authors.affiliation: Department of Otolaryngology, Himeji Red Cross Hospital, 12-1 Shimoteno 1-Chome, Himeji City, Hyogo 670-8540, Japan.
authors.forename: Yuko
authors.initials: Y
authors.lastname: Matsuyama
authors.affiliation: Department of Otolaryngology, Himeji Red Cross Hospital, 12-1 Shimoteno 1-Chome, Himeji City, Hyogo 670-8540, Japan.
authors.forename: Iku
authors.initials: I
authors.lastname: Abe
authors.affiliation: Nakada ENT Clinic, 2-2-20 Shirakuni, Himeji City, Hyogo 670-0808, Japan.
authors.forename: Michihiro
authors.initials: M
authors.lastname: Nakada
authors.affiliation: Department of Pathology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama City, Okayama 700-8558, Japan.
authors.forename: Yasuharu
authors.initials: Y
authors.lastname: Sato
authors.affiliation: Department of Otolaryngology Head and Neck Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama City, Okayama 700-8558, Japan.
authors.forename: Kazunori
authors.initials: K
authors.lastname: Nishizaki
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013968:Thyroiditis, Subacute / Q000097:blood / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000503:physiopathology; D013972:Thyrotropin / Q000097:blood; D013974:Thyroxine / Q000097:blood; D013997:Time Factors; D014463:Ultrasonography
chemical_list: D013972:Thyrotropin; D013974:Thyroxine
keywords: Abnormal laboratory findings; Onset of symptoms; Subacute thyroiditis; Time-lag