subacute thyroiditis 亚急性甲状腺炎英语病例.ppt

subacute thyroiditis Case Presentation Age：38 years old Male Chief Complaint：Fever with neck pain for 20 days. Other History Past history 、Personal history、Marital and reproductive history、Family history：No abnormality seen. Physical Examination P:105/min,R:20/min,BP:137/75mmHg，T:37.0℃ Two degree enlargement of the thyroid gland, with tenderness Heart rate 105/min accessory examination Thyroid function:FT3 13.22↑pmolo/L, FT4 46.35↑pmolo/L,TSH ＜0.005↓mIU/L, TPO 13.54 IU/ml. BRT: WBC 6.7*10^9/L, Neutrophil 73.2%. ESR:94↑mm/h. CRP:48.7↑mg/L. diagnosis Subacute thyroiditis (SAT) SAT is the most common cause of thyroid pain. It is a self-limiting inflammatory disorder associated with many viral infections. The classical course of the disease includes an initial stage of hyperthyroidism followed by a second stage of hypothyroidism, usually transitory. differential diagnosis Hashimoto thyroiditis TPOAb and TgAb rise Graves disease uptake rate of iodine increase * By june hu history of present illness 20 days ago the patient appeared fever after catching a cold accompanied with neck pain, the body temperature reaches as high as 39 degrees Celsius, no chills, no abdominal pain, no cough, no headache. the neck pain improved after taking the antibiotic and prednisone(泼尼松 ) for 3 days, but the temperature was still high. uptake rate of I 131 decreased *