Thyroiditis Flashcards
Define Thyroiditis
inflammation of the thyroid
What is Hashimoto’s thyroiditis?
AI condition involving aggressive destruction of thyroid cells by the immune system
List 5 other types of thyroiditis
de Quervain’s: viral- hyper then hypo
Postpartum: 6 months post, hyper then hypo
Drug-induced: amiodarone, lithium, interferons- either
Acute or infectious: bacterial- either
Riedel’s: AI, woody painless lump, no lymphadenopathy, associated with PSC
What 5 environmental triggers are associated with Hashimoto’s thyroiditis?
Smoking Iodine Infection Medication Diet
Give 2 facts on the epidemiology of Hashimoto’s thyroiditis
15-20X more common in F
Usually 30-50 yrs
List 10 symptoms of Hashimoto’s thyroiditis
Fatigue Cold intolerance Decreased sweating Peripheral neuropathy Depression Constipation Weight gain Menstrual irregularities Dry skin Hair loss
List 3 symptoms caused by rapid enlargement of the thyroid gland in thyroiditis
Dyspnoea
Dysphagia
Tenderness
What may eventually occur to the thyroid in thyroiditis?
Thyroid atrophy + myxoedmea
What is seen in histology in thyroiditis?
diffuse lymphocytic + plasma cell infiltration with formation of lymphoid follicles
What do TFTs show in thyroiditis?
Raised TSH
What antibodies may be present in Hashimoto’s thyroiditis?
Anti-TPO antibodies
Anti-thyroglobulin antibodies
How may ultrasound imaging be useful in a patient with thyroiditis?
To assess thyroid size, echotexture + presence of thyroid nodules.
Not necessary in diagnosing Hashimoto’s thyroiditis
Why are radioactive iodine uptake and scans used in thyroiditis?
to classify a nodule as hot or cold.
Cold = higher risk for malignancy + needs FNA biopsy.
Describe the pharmacological management of a patient with hashimotos thyroiditis
Thyroid hormone replacement: oral levothyroxine sodium
Titrate dose based on patient’s needs
In which 2 situations is surgical management required in a patient with hashimotos thyroiditis?
If a large goitre that’s causing symptoms due to compression of surrounding structures
If there is a malignant nodule
List 4 complications of hashimotos thyroiditis
Over-replacement with thyroxine, causing accelerated bone loss or increased HR
Hyperlipidaemia
Hashimoto’s encephalopathy
Myxoedema coma (due to extreme hypothyroidism)
What is the prognosis for hashimotos thyroiditis?
GOOD PROGNOSIS with early diagnosis + levothyroxine replacement
