{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T21:23:27Z","timestamp":1788211407150,"version":"build-2803163510"},"reference-count":43,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,12,23]],"date-time":"2021-12-23T00:00:00Z","timestamp":1640217600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Subacute thyroiditis (SAT) is a self-limited inflammatory thyroid disease with recurring episodes. However, the results regarding the recurrence rate and risk factors for SAT are inconsistent. This meta-analysis aimed to summarize the evidence of the recurrence rate and the risk factors for SAT.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The present study involved the performance of a systematic literature search of all English studies published in PubMed, Embase, Web of Science, and The Cochrane Library from inception to August 20, 2021. Cohort studies that reported the SAT recurrence rate and risk factors for recurrence were included. Two independent investigators extracted relevant information. Fixed- and random-effects models were used to pool effect sizes based on study heterogeneity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Eighteen cohort studies were identified. The pooled findings showed that the recurrence rate was 12.0% (95% CI: 8.2%, 17.1%). The risk of recurrence in the glucocorticoids group was higher than that in the NSAIDs group (RR = 1.84, 95% CI: 1.04, 3.24). However, there was no significant difference in age or sex between the recurrence group and the non-recurrence group. Findings from one or two cohort studies also indicated that the copresence of <jats:italic>HLA-B*18:01<\/jats:italic> and <jats:italic>-B*35<\/jats:italic>, the number of days required to taper prednisolone (PSL) to 5 mg\/day, the duration of disease before treatment less than 30 days, the sialic acid level, or the TSH level at the termination of treatment and further extension of the hypoechoic area and increase in thyroid volume were related to the recurrence of SAT.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Recurrence was common in SAT patients. The present study indicated that glucocorticoid treatment was associated with a higher recurrence rate of SAT than NSAIDs treatment. The clinical implications of this association should be interpreted with caution, and further clinical trials on the long-term effects of different treatment strategies are needed. <\/jats:p><\/jats:sec>","DOI":"10.3389\/fendo.2021.783439","type":"journal-article","created":{"date-parts":[[2021,12,23]],"date-time":"2021-12-23T20:56:24Z","timestamp":1640292984000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":22,"title":["Risk Factors for Subacute Thyroiditis Recurrence: A Systematic Review and Meta-Analysis of Cohort Studies"],"prefix":"10.3389","volume":"12","author":[{"given":"Jing","family":"Zhang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guoyong","family":"Ding","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingru","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lin","family":"Ding","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiangyun","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuxiang","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fang","family":"Tang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2021,12,23]]},"reference":[{"key":"B1","first-page":"2298","article-title":"Disorders of the Thyroid Gland","volume-title":"Harrisons Principles of Internal Medicine. 2. 19th Ed","author":"Jameson","year":"2015"},{"key":"B2","article-title":"Thyroiditis, Infectious and Subacute","volume-title":"Encyclopedia of Endocrine Diseases. 4. 2 Ed","author":"Effraimidis","year":"2018"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra021194","article-title":"Thyroiditis","volume":"348","author":"Pearce","year":"2003","journal-title":"N Engl J Med"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1950.02910250006002","article-title":"Subacute Thyroiditis","volume":"142","author":"Crile","year":"1950","journal-title":"J Am Med Assoc"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1155\/2014\/794943","article-title":"Subacute Thyroiditis: Clinical Presentation and Long Term Outcome","volume":"2014","author":"Alfadda","year":"2014","journal-title":"Int J Endocrinol"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1210\/jcem-45-2-270","article-title":"Subacute (De Quervain\u2019s) Thyroiditis: Association With HLA-Bw35 Antigen and Abnormalities of the Complement System, Immunoglobulins and Other Serum Proteins","volume":"45","author":"Nyulassy","year":"1977","journal-title":"J Clin Endocrinol Metab"},{"key":"B7","doi-asserted-by":"publisher","first-page":"534","DOI":"10.3390\/jcm9020534","article-title":"Subacute Thyroiditis Is Associated With HLA-B*18:01, -DRB1*01 and -C*04:01-the Significance of the New Molecular Background","volume":"9","author":"Stasiak","year":"2020","journal-title":"J Clin Med"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1055\/a-0998-8035","article-title":"Long-Term Outcome of Subacute Thyroiditis","volume":"128","author":"Gorges","year":"2019","journal-title":"Exp Clin Endocrinol Diabetes"},{"key":"B9","doi-asserted-by":"publisher","first-page":"97","DOI":"10.1016\/0002-9343(71)90327-5","article-title":"Subacute Thyroiditis","volume":"51","author":"Greene","year":"1971","journal-title":"Am J Med"},{"key":"B10","doi-asserted-by":"publisher","first-page":"67","DOI":"10.1530\/acta.0.1060067","article-title":"Transitory Subclinical and Permanent Hypothyroidism in the Course of Subacute Thyroiditis (De Quervain)","volume":"106","author":"Lio","year":"1984","journal-title":"Acta Endocrinol (Copenh)"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.15605\/jafes.030.02.03","article-title":"Clinical Features and Outcomes of Subacute Thyroiditis in Thai Patients","volume":"30","author":"Yotsapon","year":"2015","journal-title":"J ASEAN Fed Endocrine Soc"},{"key":"B12","doi-asserted-by":"publisher","first-page":"1089","DOI":"10.3390\/ijms20051089","article-title":"The Risk of Recurrence of Subacute Thyroiditis Is HLA-Dependent","volume":"20","author":"Stasiak","year":"2019","journal-title":"Int J Mol Sci"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.4183\/aeb.2017.119","article-title":"Is There a Drug Effect on the Development of Permanent Hypothyroidism in Subacute Thyroiditis","volume":"13","author":"Saklamaz","year":"2017","journal-title":"Acta Endocrinol (Buchar)"},{"key":"B14","doi-asserted-by":"publisher","first-page":"16899","DOI":"10.1038\/s41598-019-53475-w","article-title":"An Evaluation of the Results of the Steroid and non-Steroidal Anti-Inflammatory Drug Treatments in Subacute Thyroiditis in Relation to Persistent Hypothyroidism and Recurrence","volume":"9","author":"Sencar","year":"2019","journal-title":"Sci Rep"},{"key":"B15","article-title":"Subacute Thyroiditis in Western Saudi Arabia","volume":"26","author":"Qari","year":"2005","journal-title":"Saudi Med J"},{"key":"B16","doi-asserted-by":"publisher","first-page":"45","DOI":"10.1089\/thy.1997.7.45","article-title":"The Value of Ultrasonography in the Diagnosis and Follow-Up of Subacute Thyroiditis","volume":"7","author":"Bennedbaek","year":"1997","journal-title":"Thyroid"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.7888\/juoeh.37.103","article-title":"Prednisolone Dosing Regimen for Treatment of Subacute Thyroiditis","volume":"37","author":"Arao","year":"2015","journal-title":"J UOEH"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1210\/jcem.81.2.8636251","article-title":"Incidence of Subacute Thyroiditis Recurrences After a Prolonged Latency: 24-Year Survey","volume":"81","author":"Iitaka","year":"1996","journal-title":"J Clin Endocrinol Metab"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1001\/jama.283.15.2008","article-title":"Meta-Analysis of Observational Studies in Epidemiology: A Proposal for Reporting. Meta-Analysis of Observational Studies in Epidemiology (MOOSE) Group","volume":"283","author":"Stroup","year":"2000","journal-title":"JAMA"},{"key":"B20","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/2046-4053-4-1","article-title":"Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) 2015 Statement","volume":"4","author":"Moher","year":"2015","journal-title":"Syst Rev"},{"key":"B21","doi-asserted-by":"publisher","first-page":"45","DOI":"10.21037\/atm.2019.01.07","article-title":"Initial Treatment Combined With Prunella Vulgaris Reduced Prednisolone Consumption for Patients With Subacute Thyroiditis","volume":"7","author":"Li","year":"2019","journal-title":"Ann Transl Med"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1007\/s12020-016-1122-3","article-title":"Comparison of the Therapeutic Effects of Prednisolone and Nonsteroidal Anti-Inflammatory Drugs in Patients With Subacute Thyroiditis","volume":"55","author":"Sato","year":"2017","journal-title":"Endocrine"},{"key":"B23","unstructured":"WellsGA\n            SheaB\n            O\u2019ConnellD\n            PetersonJ\n            WelchV\n            LososM\n          The Newcastle-Ottawa Scale (NOS) for Assessing the Quality of Nonrandomised Studies in Meta-Analyses"},{"key":"B24","doi-asserted-by":"publisher","first-page":"594","DOI":"10.1016\/j.eprac.2020.11.009","article-title":"The Evaluation of Low- and High-Dose Steroid Treatments in Subacute Thyroiditis: A Retrospective Observational Study","volume":"27","author":"Hepsen","year":"2021","journal-title":"Endocr Pract"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.20945\/2359-3997000000253","article-title":"The Contribution of Ultrasonographic Findings to the Prognosis of Subacute Thyroiditis","volume":"64","author":"Sencar","year":"2020","journal-title":"Arch Endocrinol Metab"},{"key":"B26","article-title":"Clinical Characteristics of Subacute Thyroiditis is Different Than it Used to be - Current State Based on 15 Years Own Material","volume":"39","author":"Stasiak","year":"2019","journal-title":"Neuro Endocrinol Lett"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.1007\/BF03347442","article-title":"Subacute Thyroiditis: Clinical Characteristics and Treatment Outcome in Fifty-Six Consecutive Patients Diagnosed Between 1999 and 2005","volume":"30","author":"Benbassat","year":"2007","journal-title":"J Endocrinol Invest"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1007\/BF03346347","article-title":"Demographic and Clinical Features of Patients With Subacute Thyroiditis: Results of 169 Patients From a Single University Center in Turkey","volume":"30","author":"Erdem","year":"2007","journal-title":"J Endocrinol Invest"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2002-021799","article-title":"Clinical Features and Outcome of Subacute Thyroiditis in an Incidence Cohort: Olmsted County, Minnesota, Study","volume":"88","author":"Fatourechi","year":"2003","journal-title":"J Clin Endocrinol Metab"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.2169\/internalmedicine.40.292","article-title":"Evaluation of Recurrence in 36 Subacute Thyroiditis Patients Managed With Prednisolone","volume":"40","author":"Mizukoshi","year":"2001","journal-title":"Intern Med"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.1507\/endocrj.40.83","article-title":"Serum Sialic Acid Levels in the Diagnosis and Follow-Up of Subacute Granulomatous Thyroiditis","volume":"40","author":"Tajiri","year":"1993","journal-title":"Endocr J"},{"key":"B32","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.145.2.243","article-title":"Serum Thyroglobulin Levels in the Diagnosis and Follow-Up of Subacute \u2018Painful\u2019 Thyroiditis. A Sequential Study","volume":"145","author":"Madeddu","year":"1985","journal-title":"Arch Intern Med"},{"key":"B33","article-title":"Thyroiditis","volume":"73","author":"Bindra","year":"2006","journal-title":"Am Fam Physician"},{"key":"B34","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2016.0229","article-title":"2016American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis","volume":"26","author":"Ross","year":"2016","journal-title":"Thyroid"},{"key":"B35","doi-asserted-by":"publisher","DOI":"10.1089\/thy.1993.3.253","article-title":"The Management of Subacute (Dequervain\u2019s) Thyroiditis","volume":"3","author":"Volp\u00e9","year":"1993","journal-title":"Thyroid"},{"key":"B36","first-page":"1509","article-title":"Subacute\u2002(De\u2002Quervain\u2019s)\u2002Thyroiditis","volume-title":"Goldman\u2019s Cecil Medicine. 1. 25th Ed","author":"Kim","year":"2015"},{"key":"B37","doi-asserted-by":"publisher","DOI":"10.1016\/j.mcna.2012.01.003","article-title":"Subacute, Silent, and Postpartum Thyroiditis","volume":"96","author":"Samuels","year":"2012","journal-title":"Med Clinics North America"},{"key":"B38","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2012.0459","article-title":"Initial Treatment With 15 Mg of Prednisolone Daily Is Sufficient for Most Patients With Subacute Thyroiditis in Japan","volume":"23","author":"Kubota","year":"2013","journal-title":"Thyroid"},{"key":"B39","doi-asserted-by":"publisher","DOI":"10.7860\/JCDR\/2015\/14893.6427","article-title":"Treatment of Acute Painful Thyroiditis With Low Dose Prednisolone: A Study on Patients From Western Nepal","volume":"9","author":"Koirala","year":"2015","journal-title":"J Clin Diagn Res"},{"key":"B40","doi-asserted-by":"publisher","DOI":"10.2174\/2772432816666211012092112","article-title":"Identifying the Lowest Effective Initial Dose of Prednisolone for the Treatment of Subacute Granulomatous Thyroiditis a Systematic Review and Meta-Analysis","author":"Soltani","year":"2021","journal-title":"Curr Rev Clin Exp Pharmacol"},{"key":"B41","doi-asserted-by":"publisher","DOI":"10.1507\/endocrj1954.35.833","article-title":"Recurrence of Subacute Thyroiditis Over 10 Years After the First Attack in Three Cases","volume":"35","author":"Yamamoto","year":"1988","journal-title":"Endocrinol Jpn"},{"key":"B42","doi-asserted-by":"publisher","first-page":"1282","DOI":"10.3390\/genes11111282","article-title":"Strong Correlation Between HLA and Clinical Course of Subacute Thyroiditis-a Report of the Three Siblings","volume":"11","author":"Stasiak","year":"2020","journal-title":"Genes (Basel)"},{"key":"B43","article-title":"Late Recurrence of Subacute De Quervain-Crile Thyroiditis","volume":"59","author":"Fredenrich","year":"1998","journal-title":"Ann Endocrinol (Paris)"}],"container-title":["Frontiers in Endocrinology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2021.783439\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,12,23]],"date-time":"2021-12-23T20:56:35Z","timestamp":1640292995000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2021.783439\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,12,23]]},"references-count":43,"alternative-id":["10.3389\/fendo.2021.783439"],"URL":"https:\/\/doi.org\/10.3389\/fendo.2021.783439","relation":{},"ISSN":["1664-2392"],"issn-type":[{"value":"1664-2392","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,12,23]]},"article-number":"783439"}}