De Quervain’s disease – causes, symptoms, treatment

Thyroid problems are one of the more common complaints among women. One of the diseases affecting this gland is de Quervain’s disease. In the following text, you will learn what symptoms are related to it, and what causes it and what should be done to successfully treat it.

What is de Quervain’s disease?

The above is called subacute inflammation of the thyroid glands. The disease mainly occurs in women between 30 and 40 years of age. De Quervain’s disease is also referred to as one of the musculoskeletal disorders classified as enthesopathy. Very often this disorder is not recognized. It is also worth mentioning that this type of endocrine pathology is specific because it does not leave permanent damage.

Causes of de Quervain’s disease

The aetiology of subacute thyroiditis is not fully understood. Scientists indicate that the most likely way to develop this disease in the human body is a viral infection. We are talking about microorganisms causing such diseases as influenza, mononucleosis, mumps and specific types, i.e. adenoviruses (Coxsackie or ECHO). In addition to infection, there is often mention of the body’s innate predisposition to develop de Quervain’s disease, which is conditioned by the HLA-Bw35 antigen.

What are the symptoms of de Quervain’s disease?

The occurrence of symptoms in de Quervain’s disease is conditioned by the phase development of the disease itself. In the initial period, which is associated with damage to the thyroid gland, first of all, symptoms of hyperthyroidism of this gland (i.e. hyperthyroidism) develop – we are talking mainly about diarrhoea, excessive weight loss, hyperactivity, shortness of breath, increased sweating, palpitations, trembling hands or significant sleep problems. Very often fever develops and there is significant pain in the thyroid area, which usually radiates to the occiput, ear or jaw. Patients often mention the presence of muscular and osteoarticular pain. The implementation stage of subacute thyroiditis usually lasts 4 to 6 weeks.

After this period, symptoms usually disappear spontaneously. However, the disease process does not end. De Quervain’s disease begins to progress and this time causes hypothyroidism (hypothyroidism) to appear. This stage occurs in more than 1/3 of all patients with subacute thyroiditis. The most frequently indicated signs are the development of depressive states, increased sensitivity to cold and faster freezing, decreased tone of the voice, excessive dryness of the skin, the appearance of swelling on the face and constipation.

Based on the above clinical picture of the patient, it is possible to recognize de Quervain’s disease. In the case of diagnostics, we distinguish two basic groups of criteria

  • enlargement of the thyroid glands accompanied by pain
  • a marked increase in OB in blood tests
  • a characteristic picture of histopathological examination in the material taken from the examined
  • reduction of iodine uptake in scintigraphy
  • signs of hyperthyroidism (drop-in TSH, increase in FT3 and FT4)
  • no presence of thyroid antibodies

The presence of 2 main and 2 additional criteria confirms the occurrence of subacute thyroiditis.

De Quervain’s disease – treatment

Although de Quervain’s disease passes spontaneously and does not cause irreversible damage to the thyroid glands, patients should undergo specific therapy. Treatment of subacute thyroiditis is mainly of asymptomatic nature, the purpose of which is to alleviate the alternating symptoms of hyperthyroidism or hypothyroidism. In practice, the most commonly used pharmacological agents are based on glucocorticosteroids, which quickly eliminate pain related to this disease.

The treatment process usually lasts from 6 weeks to even half a year, which is largely dictated by both the stage of the disease itself and its symptoms. Patients are usually cured completely and recurrences of pathology occur very rarely.