Subacute thyroiditis presenting with creeping in a 6-year-oldboy

摘要

Among the types of acute thyroiditis, subacute thyroiditis (SAT) is rare in children, andthere is limited knowledge regarding its characteristics in pediatric cases. We present acase of SAT in a 6-yr-old boy who was brought to our hospital with high fever and pain inthe front portion of the neck. Acute suppurative thyroiditis (AST), which is common inchildren, was suspected initially. Tenderness observed in the thyroid corresponded to ahypoechoic region on ultrasonography. The tenderness subsequently shifted to the isthmus,which was evident as a hypoechoic region on ultrasonography. Movement of hypoechoicity istypical of creeping thyroiditis, wherein the pain and tenderness can be unilateral or maystart on one side and subsequently shift to the contralateral side after days or evenweeks. Based on this characteristic and changes in laboratory parameters, the patient wasdiagnosed as a case of creeping thyroiditis. Improvement was observed in the patientwithout the use of anti-inflammatory drugs. At the 2-yr follow-up, the patient did nothave thyrotoxicosis or relapse. Although AST is more prevalent than SAT in children,ultrasonography findings of creeping thyroiditis may be an important indicator for thediagnosis of SAT in pediatric patients.Subacute thyroiditis (SAT) is thought to be caused by viral infection; however, thecondition rarely occurs in children. Moreover , the clinical features of SAT in thepediatric population are not well-understood (1).Creeping thyroiditis, a condition in which pain and tenderness gradually shifts to theopposite lobe of the thyroid gland, is a feature of adult SAT (2, 3). In this report, we present arare case of SAT in a young boy who experienced unilateral pain in the neck that shifted tothe opposite side before resolving spontaneously.