Endocrinology Book

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Radiation-Induced Thyroiditis

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  1. Definition
    1. Acute Thyroiditis due to neck radiation
  2. Epidemiology: Incidence
    1. Occurs in 1% of patients on I-131 for Hyperthyroidism
  3. Causes
    1. Radioiodine therapy (I-131) for Hyperthyroidism
    2. Head and neck radiation for Lymphoma
      1. High dose irradiation
      2. Pre-existing Hypothyroidism
      3. Younger women
  4. Symptoms
    1. Thyroid pain onset in first 1-2 weeks after I-131
  5. Signs
    1. Thyroid tenderness to palpation
  6. Labs
    1. Thyroid Function Tests (TSH, T4 Free)
      1. Hyperthyroidism surges temporarily
  7. Management
    1. Thyroid Pain
      1. NSAIDs
      2. Prednisone if refractory to NSAIDs
        1. Short course at 40-60 mg orally daily with taper
    2. Hyperthyroidism symptoms
      1. Beta Blocker (e.g. Propranolol)
  8. Course
    1. Resolves in 6-18 weeks as Thyroid fibrosis occurs
  9. References
    1. Bindra (2006) Am Fam Physician 73:1769
    2. Jereczek (2004) Cancer Treat Rev 30:369

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