Thyroiditis Flashcards
def
inflammation of the thyroid
does thyroiditis cause high or low thyroid hormones
can be either
what are the common forms of thyroiditis
AUTOIMMUNE THYROIDITIS 1 Hashimoto's thyroiditis (most common) 2 past partum thyroiditis 3 silent or painless thyroiditis NON-AUTOIMMUNE THYROIDITIS 1 de quervains thyroiditis AKA granulomatous thyroiditis 2 drug or radiation induced thyroiditis 3 acute or infectious thyroiditis
what is hashimotos thyroiditis
autoimmune condition in which the thyroid gland is slowly destroyed
what causes hashimotos thyroiditis
genetic and environmental factors which causes antithyroid antibodies which attack the thyroid
epi of hashimotos thyroiditis
most common cause of hypothyroidism
women>men
history + examination of hashimotos thyroiditis
history -symptoms of hypothyroidism examination -signs of hypothyroidism -painless goitre
investigations of hashimotos thyroiditis
antibodies against thyroid peroxidase
risk factors of hashimotos thyroiditis
family history of condition
autoimmune disease
management of hashimotos thyroiditis
levothyroxine
complications of hashimotos thyroiditis
thyroid lymphoma
prognosis of hashimotos thyroiditis
generally good
what is post-partum thyroiditis
observed after pregnancy which gives hyperthyroidism, hypothyroidism or the two sequentially
epi of post-partum thyroiditis
uncommon in post-partum women
aetiology of post-partum thyroiditis
due to changes in the immune system in pregnancy this causes antithyroid antibodies
prognosis of post-partum thyroiditis
known as the resolving thyroiditis
history + examination of post-partum thyroiditis
hyperthyroidism usually occurs first followed by hypothyroidism (which is generally more severe so is when patients present)
investigations of post-partum thyroiditis
a suppressed TSH could indicate the hyperthyroid phase
a low T3/4 with raised TSH could indicate the hypothyroid phase
management
the hyperthyroid phase is generally quite mild and may require beta-blockers or nothing
the hypothyroid phase is more severe and if the TSH is very high, levothyroxine may be required
silent or painless thyroiditis
inflammation of the thyroid gland
autoimmune reaction against the thyroid gland leading to hyperthyroidism followed by hypothyroidism
women>men
symptoms + signs of hyperthyroidism followed by symptoms + signs of hypothyroidism
TFTs
what is de quervains thyroiditis
AKA as subacute granulomatous thyroiditis
it is painful thyroiditis
aetiology of de quervains thyroiditis
can be preceded by URTI
viral causes include coxsackie, mumps, adenoviruses
history + examination
hyperthyroid phase followed by a hypothyroid phase
symptoms of hyperthyroidism followed by symptoms of hypothyroidism
there may be painful dysphagia
investigation
similar presentation to diffuse toxic goiter or graves disease
radionuclide thyroid uptake:
-decreased uptake in thyroiditis
-increased uptake in graves disease
prognosis
a resolving thyroiditis
what medications can cause drug induced thyroiditis
amiodarone
lithium
features of drug induced thyroiditis
pain
what is radiation induced thyroiditis
after radioactive iodine treatment for an overactive thyroid
the low levels of thyroid hormone after radioactive iodine is normally permanent
features of acute or infectious thyroiditis
triggered by bacterial infection
pain in the throat, malaise
symptoms of hyperthyroidism, symptoms of hypothyroidism
antibiotics for infection
a 62y/o man presents with AF. He has not noticed, tremors, heat intolerance, weight loss. His thyroid gland is non-nodular, non-tender, and slightly enlarged. Serum TSH is low, T4 and T3 are raised. He is positive for thyroid peroxidase antibodies, and there is a low radioiodine uptake.
thyroid peroxidase antibodies (hashimotos)
low radioiodine
thyroiditis
