Endocrine Abstracts

JOINT1160

Heterogenous clinical picture, variety of non-specific symptoms and atypical presentation may pose a diagnostic challenge in some patients with subacute thyroiditis (SAT). SAT occurs most often in young and middle-aged women. It is a self-limited inflammatory disease, but in many cases the resolution of symptoms can be achieved only by a medical treatment, and relapses are possible. The diagnosis of SAT in hyperthyroid phase was established in two 77 and 68-year-old female patients, due to self-referral to endocrinologist 10-20 days after the first symptoms had appeared. Both had a history of SAT 20,5 - 20 years ago, at the age of 56 and 48 years, respectively. Both received corticosteroids and stayed euthyroid after the end of treatment. Diagnostic delay in the first episode was more than 2 months. One patient was followed with a diagnosis of upper respiratory tract infection (treated with antibiotics) and mild anemia. In another woman clinical manifestations of SAT were initially regarded as symptoms of menopause. These cases demonstrate late recurrences of SAT two decades after complete recovery in two female patients of advanced age. Primary care physicians need to be better aware of SAT symptoms. At the same time, patients with medical history of SAT should be informed about potential repeated episodes at any age during lifetime. Prompt self-referral in case of resumption of suspicious manifestations, resembling those during the first attack, can reduce diagnostic delay, help to establish correct diagnosis, avoid unnecessary investigations and treatment.