以颈咽疼痛首诊耳鼻咽喉科的亚急性甲状腺炎26例报告

Sub-acute thyroiditis with pain in neck and pharynx as the first complaint-a report of 26 cases

目的 总结分析首诊于耳鼻咽喉科的亚急性甲状腺炎(SAT)的临床诊疗问题。方法 回顾性研究26例亚急性甲状腺炎,对其临床诊疗情况进行分析。结果 全部患者均有颈咽疼痛、甲状腺肿大及触痛。21例T3、T4与甲状腺摄碘率呈分离现象。易误诊为上呼吸道感染、扁桃体炎、甲状腺机能亢进症等。强的松和非甾体类药物治疗效果良好。结论 对咽喉疼痛与体征不符的患者,须行甲状腺检查以防漏诊本病。

Objectives To sum up the experience in the diagnosis and treatment of cases with sub-acute thyroiditis with pain in neck and pharynx as the first complaint to consult his/her otolaryngologist. Methods A retrospective study was carried out among 26 cases with this lesion,treated in our Hospital to analyze their clinical data collected in the diagnosing and treating course. Results All the 26 cases compained pain in neck and pharynx,with swollen thyroid and tenderness here found. Among them, 21 showed a dissociation of T3 and T4 levels from131I absorbing rate in thyroid. This condition might be easily misdiagnosed with upper respiratory tract infection, tonsillitis and hyperthyroidism, while it was well reacted to the therapy of prednisone and nonsteroid drugs. Conclusions For those cases with a contradiction in the symptom of pain in neck and pharynx with their physical signs,tests for thyroid must be given in order to avoiding misdiagnosis of sub-acute thyroiditis.