Subacute thyroiditis — SCE Endocrinology MCQ

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ModerateThyroidSubacute thyroiditisSCE Endocrinology

A 42-year-old man has anterior neck pain radiating to the jaw 3 weeks after an upper respiratory tract infection. TSH is <0.01 mU/L, free T4 is 36 pmol/L, ESR is 78 mm/hour and TSH receptor antibodies are negative. The thyroid is tender. What is the most likely biochemical finding?

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Correct answer: E — Low radioiodine uptake

Subacute thyroiditis causes release of preformed hormone from an inflamed gland, so isotope uptake is low. Graves' disease causes high diffuse uptake because hormone synthesis is increased. The pearl is that thyroiditis is a destructive process, not a hyper-synthetic one.

Reference: NICE NG145, BNF