{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T17:06:42Z","timestamp":1791824802817,"version":"4.3.4"},"reference-count":27,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2025,4,28]],"date-time":"2025-04-28T00:00:00Z","timestamp":1745798400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>Subacute thyroiditis (SAT) represents an inflammatory disease of the thyroid gland, often resulting from viral infections or post-viral inflammatory responses. Long-term hypothyroidism is a possible evolution, requiring frequent follow-up and, if necessary, levothyroxine (LT4) replacement therapy. We retrospectively included 139 patients (out of 428) with SAT referring to the \u201cFondazione Policlinico Universitario A. Gemelli IRCCS\u201d (Rome), between 2010 and 2022 to identify predictive parameters for long-term hypothyroidism. We evaluated TSH, FT4, and FT3 at four timepoints (diagnosis, 4\u20138 weeks, 10\u201320 weeks, and 28\u201354 weeks). We started LT4 therapy in patients with TSH &gt; 10 \u03bcUI\/mL or between 4\u201310 \u03bcUI\/mL, with symptoms of hypothyroidism. \u201cLong-term hypothyroidism\u201d was defined as TSH &gt; 4 \u03bcUI\/mL after LT4 reduction and\/or withdrawal. Univariate analysis showed correlations between long-term hypothyroidism and higher FT3 and FT4 and positive anti-Tg Abs at diagnosis and higher changes in TSH values (\u0394TSH), decreased thyroid volume, and persistence of hypoechoic areas during follow-up. Furthermore, more severe thyrotoxicosis at presentation may be associated with a faster progression to hypothyroidism, likely due to greater thyroid damage. Multivariable analysis found \u0394TSH (TP2-TP1) as an independent predictor of hypothyroidism. We propose specific biochemical and ultrasonographic parameters at diagnosis and during follow-up as possible predictors of long-term hypothyroidism after SAT, reducing treatment and healthcare costs for most patients who will never require replacement therapy.<\/jats:p>","DOI":"10.3390\/ijms26094176","type":"journal-article","created":{"date-parts":[[2025,4,28]],"date-time":"2025-04-28T11:48:33Z","timestamp":1745840913000},"page":"4176","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Biochemical and Ultrasonographic Parameters Predicting Long-Term Hypothyroidism After Subacute Thyroiditis"],"prefix":"10.3390","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8167-4338","authenticated-orcid":false,"given":"Andrea","family":"Corsello","sequence":"first","affiliation":[{"name":"Unit of Endocrine Surgery, Ospedale Isola Tiberina-Gemelli Isola, 00186 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-5419-3261","authenticated-orcid":false,"given":"Piergiacomo Maria","family":"Cacciamani Fanelli","sequence":"additional","affiliation":[{"name":"Unit of Endocrinology, Department of Translational Medicine and Surgery, Universit\u00e0 Cattolica del Sacro Cuore, Fondazione Policlinico \u201cA. Gemelli\u201d IRCCS, 00136 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luisa","family":"Lener","sequence":"additional","affiliation":[{"name":"Unit of Endocrinology, Department of Translational Medicine and Surgery, Universit\u00e0 Cattolica del Sacro Cuore, Fondazione Policlinico \u201cA. Gemelli\u201d IRCCS, 00136 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6857-2660","authenticated-orcid":false,"given":"Gianluca","family":"Cera","sequence":"additional","affiliation":[{"name":"Unit of Endocrinology, Department of Translational Medicine and Surgery, Universit\u00e0 Cattolica del Sacro Cuore, Fondazione Policlinico \u201cA. Gemelli\u201d IRCCS, 00136 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4772-1417","authenticated-orcid":false,"given":"Pietro","family":"Locantore","sequence":"additional","affiliation":[{"name":"Unit of Endocrinology, Department of Translational Medicine and Surgery, Universit\u00e0 Cattolica del Sacro Cuore, Fondazione Policlinico \u201cA. Gemelli\u201d IRCCS, 00136 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alfredo","family":"Pontecorvi","sequence":"additional","affiliation":[{"name":"Unit of Endocrinology, Department of Translational Medicine and Surgery, Universit\u00e0 Cattolica del Sacro Cuore, Fondazione Policlinico \u201cA. Gemelli\u201d IRCCS, 00136 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salvatore Maria","family":"Corsello","sequence":"additional","affiliation":[{"name":"Unit of Endocrinology, Department of Translational Medicine and Surgery, Universit\u00e0 Cattolica del Sacro Cuore, Fondazione Policlinico \u201cA. Gemelli\u201d IRCCS, 00136 Rome, Italy"},{"name":"Departmental Faculty of Medicine, Unicamillus-Saint Camillus International University of Health Sciences, 00131 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosa Maria","family":"Paragliola","sequence":"additional","affiliation":[{"name":"Departmental Faculty of Medicine, Unicamillus-Saint Camillus International University of Health Sciences, 00131 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,4,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1027","DOI":"10.1007\/s11154-021-09648-y","article-title":"New aspects in the pathogenesis and management of subacute thyroiditis","volume":"22","author":"Stasiak","year":"2021","journal-title":"Rev. Endocr. Metab. 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