A person has fever & pain in thyroid gland. True statement(s) is/are:

Ans: B (| ESR) "In the thyrotoxic phases, T4 A T3 .levels are increased reflecting their discharge from the damaged thyroid cells & TSH is suppressed. T4 / T3 ratio is greater than in Grave's disease or thyroid autonomy, in which T3 is often disproportionately increased. Finally .the thyroid hormones & TSH levels return to normal, as the disease subsides The diagnosis is confirmed by a high ESR & low radioiodine uptake - HI7th/ 2238 De Quervain's /Subacute/Viral/Granulomatous Thyroiditis : Short Review # The peak incidence occur at 30 to 50 years # Women are affected three times more frequently than men # Clinical Picture * The patient usually presents with a painful & enlarged thyroid, sometimes accompanied byfeveft. * Malaise & symptoms of an upper respiratory tract infection may precede the thyroid related feature by several weeks * Examination may reveals a small goiter that is exquisitely tender * There may be feature of thyrotoxicosis or hypothyroidism, depending on phase of illness * Complete resolution is usual outcome, but permanent hypothyroidism can occur # It is caused by a viral infectionMany viruses have been implicated including mumps, coxsackie, influenza, adenovirus & echoviruses # Laboratory Finding * Serum IL-6 level increases during the thyrotoxic phase * The WBC count may be increased & thyroid antibodies are negative * If the diagnosis is in doubt FNAC may be useful # Treatment * NSAID5 & glucocorticoids may be used to relieve pain * If thyroid failure is prominent, treatment with thyroxine may be required until function recovers