{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T10:17:19Z","timestamp":1788171439459,"version":"build-2803163510"},"reference-count":108,"publisher":"BioExcel","license":[{"start":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T00:00:00Z","timestamp":1788134400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["DIC"],"abstract":"<jats:p>Subacute thyroiditis (SAT) is a self-limited inflammatory thyroid disorder classically characterized by anterior neck pain, an enlarged tender thyroid, fever, fatigue, malaise, elevated inflammatory markers and a triphasic course from thyrotoxicosis through hypothyroidism to recovery. It can cause substantial morbidity and remains a frequent diagnostic challenge because it must be distinguished from acute suppurative thyroiditis, Graves\u2019 disease, painless thyroiditis, haemorrhage into a nodule and, rarely, malignant \u2018pseudothyroiditis\u2019 (rapidly growing carcinoma). In recent years, the recognized spectrum of triggers has expanded beyond the classical post-viral setting to include SARS-CoV-2 infection or vaccination. This review summarizes current understanding of SAT pathogenesis, including viral and post-viral mechanisms, and HLA-linked susceptibility. We outline the typical and variant clinical phenotypes, emphasising painful classical SAT, painless presentations, pregnancyassociated disease and therapy-related destructive thyroiditis. We then present a practical diagnostic framework based on clinical features, inflammatory markers, thyroid function tests, radionuclide imaging, ultrasound and fine-needle aspiration, when indicated. Management is discussed in a stepwise fashion, including NSAIDs and glucocorticoids for pain and inflammation, \u03b2-blockers for symptomatic thyrotoxicosis, selective levothyroxine replacement during the hypothyroid phase, and structured follow-up to detect recurrence and permanent hypothyroidism. Special attention is given to pregnancy and SARS-CoV-2-related SAT cases. Finally, we review longterm outcomes, recurrence risk and future research priorities. The aim is to provide a concise, clinically oriented guide to the contemporary management of SAT and to support rational, evidence-informed decision-making in routine endocrine practice.\n\nDownload the Plain Language Summary of this article: https:\/\/www.drugsincontext.com\/plain-language-summaries\/plain-language-summary-how-to-manage-subacute-thyroiditis\n\nThis article is part of the How to manage thyroid diseases: from autoimmunity to malignancy Special Issue: https:\/\/www.drugsincontext.com\/how-to-manage-thyroid-diseases-from-autoimmunity-to-malignancy<\/jats:p>","DOI":"10.7573\/dic.2026-4-6","type":"journal-article","created":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T09:39:59Z","timestamp":1788169199000},"page":"1","source":"Crossref","is-referenced-by-count":0,"title":["How to manage subacute thyroiditis"],"prefix":"10.7573","author":[{"given":"Grigoris","family":"Effraimidis","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/04v4g9h31","id-type":"ROR","asserted-by":"publisher"}],"name":"University of Thessaly"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Athanasios","family":"Kasotas","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/01s5dt366","id-type":"ROR","asserted-by":"publisher"}],"name":"University Hospital of Larissa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georgios K","family":"Markantes","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/017wvtq80","id-type":"ROR","asserted-by":"publisher"}],"name":"University of Patras"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olga","family":"Karapanou","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00y1kmp77","id-type":"ROR","asserted-by":"publisher"}],"name":"NIMTS Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katerina","family":"Saltiki","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/04gnjpq42","id-type":"ROR","asserted-by":"publisher"}],"name":"National and Kapodistrian University of Athens"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marina","family":"Michalaki","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/017wvtq80","id-type":"ROR","asserted-by":"publisher"}],"name":"University of Patras"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10047","published-online":{"date-parts":[[2026,8,31]]},"reference":[{"key":"ref0","doi-asserted-by":"crossref","unstructured":"1.\tSzabo SM, Allen DB. 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