II. Definition

  1. Acute Thyroiditis due to neck radiation

III. Epidemiology: Incidence

  1. Occurs in 1% of patients on I-131 for Hyperthyroidism

IV. 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

V. Symptoms

  1. Thyroid pain onset in first 1-2 weeks after I-131

VI. Signs

  1. Thyroid tenderness to palpation

VII. Labs

  1. Thyroid Function Tests (TSH, T4 Free)
    1. Hyperthyroidism surges temporarily

VIII. 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)

IX. Course

  1. Resolves in 6-18 weeks as Thyroid fibrosis occurs

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