Two-Years Prospective Follow-Up Study of Subacute Thyroiditis

Abstract

Purpose: The aim of the present prospective follow-up study was to explore the early indicators of hypothyroidism and the final changes in thyroid volume in subacute thyroiditis (SAT) patients. Methods: We enrolled 61 SAT patients and followed them up for 2 years to assess the incidence of hypothyroidism and changes in thyroid volume. Binary logistic regression and receiver operating characteristic (ROC) curves were used for data analysis. Results: During the 2 years follow-up period, we found that the volumes of the thyroid gland in SAT patients at 1 and 2 years were significantly smaller than those in the healthy control group, which were significantly smaller compared to the initial thyroid volumes after SAT onset (p < 0.001). Also, the thyroid volumes of SAT patients with hypothyroidism were significantly smaller than those of SAT patients without hypothyroidism. The early maximum thyroid-stimulating hormone (TSH) values (within 3 months after SAT onset) were closely related to the incidence of hypothyroidism at 2 years. The OR value was 1.18 (95% CI = 1.01-1.38, p = 0.032). The early maximum TSH value had a maximum area under the ROC curve (AUC) of 0.866 for the development of hypothyroidism 2 years after SAT onset vs. euthyroidism (p < 0.001). Conclusions: The thyroid volumes of patients increased significantly after the onset of SAT, while during the follow-up these volumes decreased; the thyroid volumes at 1 and 2 years were significantly smaller than those of normal healthy subjects, especially in SAT patients with hypothyroidism. Furthermore, the early maximum TSH value could be used as an effective indicator of the development of hypothyroidism 2 years after the onset of SAT.

Keywords: TSH; hypothyroidism; subacute thyroiditis; thyroid volume; ultrasonography.

Figure 1

Receiver operating characteristic (ROC) curves assessing the risk of hypothyroidism 2 years after the onset of SAT based on the early maximum TSH value.

Figure 2

The thyroid volume of subacute thyroiditis (SAT) at 1 and 2 years was significantly smaller. (A) Comparison of the thyroid gland volumes between SAT patients at initial, 1 and 2 years of follow-up and those of healthy controls. (B) Comparison of thyroid volumes of SAT patients after 1 year and 2 years of hypothyroidism with those of euthyroid individuals.