Sandbox:DDx HEENT
- 30-50 yo women, self limited
- Subacute onset
- Painful neck swelling with fever, malaise, and fatigue
- Symptoms of thyrotoxicosis followed by transient hypothyroid symptoms
- Tender mid-line neck swelling
- Initial increase in T3 and T4 with decreased TSH
- Followed by decrease in T3 and T4 with increased TSH
- Return to normal baseline thyroid function
- Poorly defined hypechogenic region on U/S
- Decreased vascularity in the affected areas
- Low uptake thyroid iodine scan
- Accumulation of neutrophils with follicular destruction and colloid depletion
- Noncaseating granulomas formation
- Fibrosis may develop
- HLA-B35