An Evaluation of the Results of the Steroid and Non-steroidal Anti-inflammatory Drug Treatments in Subacute Thyroiditis in relation to Persistent Hypothyroidism and Recurrence
Autor: | Ilknur Ozturk Unsal, Davut Sakiz, Murat Calapkulu, Muhammed Kizilgul, Arif Kus, Erman Cakal, Bekir Ucan, Pinar Akhanli, Mustafa Ozbek, Sema Hepsen, Muhammed Erkam Sencar |
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Jazyk: | angličtina |
Rok vydání: | 2019 |
Předmět: |
Adult
Male medicine.medical_specialty medicine.medical_treatment Thyroid Gland lcsh:Medicine Ibuprofen 030209 endocrinology & metabolism Methylprednisolone Gastroenterology Article 030218 nuclear medicine & medical imaging Steroid Prognostic markers 03 medical and health sciences 0302 clinical medicine Hypothyroidism Recurrence Thyroid peroxidase Internal medicine medicine Humans Treatment Failure Thyroiditis Subacute lcsh:Science Retrospective Studies Ultrasonography Subacute thyroiditis Multidisciplinary biology business.industry Thyroid disease Anti-Inflammatory Agents Non-Steroidal Therapeutic effect lcsh:R Acute-phase protein Middle Aged medicine.disease Thyroid diseases biology.protein Female lcsh:Q business medicine.drug |
Zdroj: | Scientific Reports, Vol 9, Iss 1, Pp 1-8 (2019) Scientific Reports |
ISSN: | 2045-2322 |
Popis: | Subacute thyroiditis (SAT) is an inflammatory thyroid disease. The main purpose of the treatment is to relieve pain and control the inflammatory process. The aim of the present study was to evaluate the therapeutic effects of steroid and non-steroidal anti-inflammatory drugs (NSAIDs) in SAT. Initial laboratory data, treatment response, and long-term results of 295 SAT patients treated with ibuprofen or methylprednisolone were evaluated. After the exclusion of 78 patients, evaluation was made of 126 patients treated with 1800 mg ibuprofen and 91 patients treated with 48 mg methylprednisolone. In 59.5% of 126 patients treated with ibuprofen, there was no adequate clinical response at the first control visit. In 54% of patients, the treatment was changed to steroids in mean 9.5 days. Symptomatic remission was achieved within two weeks in all patients treated with methylprednisolone. The total recurrence rate was 19.8%, and recurrences were observed more frequently in patients receiving only steroid therapy than in patients treated with NSAID only (23% vs. 10.5% p:0.04). Persistent hypothyroidism developed in 22.8% of patients treated only with ibuprofen and in 6.6% of patients treated with methylprednisolone only. Treatment with only ibuprofen (p:0.039) and positive thyroid peroxidase antibody (anti-TPO) (p:0.029) were determined as the main risk factors for permanent hypothyroidism. NSAID treatment is not as effective as steroid treatment in early clinical remission. Steroid treatment was detected as a protective factor against permanent hypothyroidism. Therefore, steroid therapy may be considered especially in anti-TPO positive SAT patients and patients with high-level acute phase reactants. |
Databáze: | OpenAIRE |
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