Pharm

Radiation-Induced Thyroiditis

search

Radiation-Induced Thyroiditis

  • Definition
  1. Acute Thyroiditis due to neck radiation
  1. Occurs in 1% of patients on I-131 for Hyperthyroidism
  • 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
  • Symptoms
  1. Anterior Neck Pain or Thyroid pain
    1. Onset in first 1-2 weeks after I-131 or other neck Radiation Therapy
  • Signs
  1. Thyroid tenderness to palpation
  2. Thyroid Gland enlargement
  • Labs
  1. Thyroid Function Tests (TSH, T4 Free)
    1. Hyperthyroidism surges temporarily
  • Management
  1. Thyroid Pain
    1. NSAIDs
    2. Prednisone if refractory to NSAIDs (rarely needed)
      1. Short course at 40-60 mg orally daily with taper
  2. Hyperthyroidism symptoms
    1. Beta Blocker (e.g. Propranolol)
  • Course
  1. Resolves in 6-18 weeks (typically by 4 weeks) as Thyroid fibrosis occurs
  • References
  1. Bindra (2006) Am Fam Physician 73:1769-76 [PubMed]
  2. Jereczek (2004) Cancer Treat Rev 30:369-84 [PubMed]
  3. Quintero (2021) Am Fam Physician 104(6): 609-17 [PubMed]