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Table 3. Comparison between painful HT and SAT

HT SAT

Prior goiter Usual Rare
Prior AITD Usual No
Prior URTI Infrequent Frequent
Pain/tenderness Present, may be extreme Extreme
Goiter at onset Yes Yes
Thyrotoxicosis at onset Variable Yes, usually
RAIU Low or normal or high Very low
Free thyroxine index Variable Variable
CRP/ESR Normal or elevated Elevated
MCAB Usually strong positive Negative or weak
Pathology Fibrosis, lymphocytes Giant cells, polymorphs
Steroid response Yes or no Yes
Risk of long-term hypothyroidism Yes Rare
Treatment T4, acetaminophen, aspirin, NSAID steroids, thyroidectomy Acetaminophen, aspirin, NSAID, steroids

AITD, Autoimmune thyroid disease; MCAB, monoclonal antibody.





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