De Quervain's thyroiditis pathophysiology

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De Quervain's thyroiditis Microchapters


Patient Information


Historical Perspective




Differentiating De Quervain's thyroiditis from other Diseases

Epidemiology and Demographics

Risk Factors


Natural History, Complications, and Prognosis


Diagnostic Criteria

History and Symptoms

Physical Examination

Laboratory Findings


Chest X Ray



Echocardiography or Ultrasound

Other Imaging Findings

Other Diagnostic Studies


Medical Therapy


Primary prevention

Secondary prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Furqan M M. M.B.B.S[2]


The exact pathogenesis of de Quervain's thyroiditis is unclear. It is proposed that cytotoxic T cell recognition of complex viral and cell antigens presentation leads to the thyroid follicular cell damage which is responsible for the pathogenesis of de Quervain's thyroiditis. De Quervain's thyroiditis is usually preceded by a viral prodrome and also have a genetic predisposition. HLA B35 and HLA B15/62 are associated with de Quervain's thyroiditis.


The control, synthesis, and release of the thyroid hormone is usually controlled by hypothalamus and pituitary gland.[1][2]
Regulation of thyroid hormone secretion. Source:By CFCF; slightly modified by Geo-Science-International - This file was derived from Thyroid vector.svg:, CC BY-SA 3.0,


The exact pathogenesis of de Quervain's thyroiditis is unclear, but autoimmunity mechanism is proposed.[3][4][5]


Associated conditions

The following conditions may be associated with De Quervain's thyroiditis:[8]

Gross Pathology

On gross pathology, subacute thyroiditis frequently resembles thyroid malignancy. Subacute thyroiditis usually has the following features:[9]

  • Firm to dense consistency
  • Pale white color
  • Poorly defined margins
  • Involvement of adjacent normal thyroid

Microscopic pathology

The primary pathology of de Quervain's thyroiditis is:[3][9]

  • Infiltration with polymorphonuclear leukocytes initially
  • Predominance of lymphocytes and macrophages in advanced form
  • Destruction of the follicular epithelium
  • Parenchymal destruction and scar tissue
  • Loss of the follicular integrity



  1. De Groot LJ, Chrousos G, Dungan K, Feingold KR, Grossman A, Hershman JM, Koch C, Korbonits M, McLachlan R, New M, Purnell J, Rebar R, Singer F, Vinik A, Rousset B, Dupuy C, Miot F, Dumont J. "Thyroid Hormone Synthesis And Secretion". PMID 25905405.
  2. Kirsten D (2000). "The thyroid gland: physiology and pathophysiology". Neonatal Netw. 19 (8): 11–26. doi:10.1891/0730-0832.19.8.11. PMID 11949270.
  3. 3.0 3.1 Kojima M, Nakamura S, Oyama T, Sugihara S, Sakata N, Masawa N (2002). "Cellular composition of subacute thyroiditis. an immunohistochemical study of six cases". Pathol. Res. Pract. 198 (12): 833–7. doi:10.1078/0344-0338-00344. PMID 12608662.
  4. Erdem N, Erdogan M, Ozbek M, Karadeniz M, Cetinkalp S, Ozgen AG, Saygili F, Yilmaz C, Tuzun M, Kabalak T (2007). "Demographic and clinical features of patients with subacute thyroiditis: results of 169 patients from a single university center in Turkey". J. Endocrinol. Invest. 30 (7): 546–50. PMID 17848836.
  5. Desailloud R, Hober D (2009). "Viruses and thyroiditis: an update". Virol. J. 6: 5. doi:10.1186/1743-422X-6-5. PMC 2654877. PMID 19138419.
  6. Nyulassy S, Hnilica P, Buc M, Guman M, Hirschová V, Stefanovic J (1977). "Subacute (de Quervain's) thyroiditis: association with HLA-Bw35 antigen and abnormalities of the complement system, immunoglobulins and other serum proteins". J. Clin. Endocrinol. Metab. 45 (2): 270–4. doi:10.1210/jcem-45-2-270. PMID 885992.
  7. de Bruin TW, Riekhoff FP, de Boer JJ (1990). "An outbreak of thyrotoxicosis due to atypical subacute thyroiditis". J. Clin. Endocrinol. Metab. 70 (2): 396–402. doi:10.1210/jcem-70-2-396. PMID 2298855.
  8. Fatourechi V, Aniszewski JP, Fatourechi GZ, Atkinson EJ, Jacobsen SJ (2003). "Clinical features and outcome of subacute thyroiditis in an incidence cohort: Olmsted County, Minnesota, study". J. Clin. Endocrinol. Metab. 88 (5): 2100–5. doi:10.1210/jc.2002-021799. PMID 12727961.
  9. 9.0 9.1 Shrestha RT, Hennessey J. Acute and Subacute, and Riedel’s Thyroiditis.