Thyroiditis Flashcards
Thyroiditis
Inflammation of the thyroid
Thyroiditis Aetiology
Hashimotos De Quervains (subacute) : Viral Post-partum Drug Induced (amiodarone, lithium) Radiation Acute Suppurative (bacterial)
Subacute Thyroiditis
Female> Male
Ages 25-50
May be triggered by viral infection
Subacute Thyroiditis Associations
may be associated with
- neck tenderness
- fever
- typical viral symptom
Usually self-limiting over a few months
Amiodarone Effect on Thyroid
TFTs abnormal in up to 50% of patients
- Inhibition of DIO1.
- increased fT4
- Decreased fT3
- normal TSH
Hypothyroidism in 13%
hyperthyroidism in 2%
- Type 1: Similar to Graves
- Type 2: destructive thyroiditis
- Mixed
Subclinical Thyroid Disease
Abnormal TSH with normal T3./T4
subclinical Hypothyroidism
Increased TSH
Risk of progression to overt hypothyroidism
Higher risk if strongly TPO antibody positive
Treatment advised if TSH>10
Always treat in pregnancy to maintain normal TSH
Subclinical Hyperthyroidism
Decreased TSH
Risk of progression to overt hyperthyroidism
Often seen in multi nodular goitre
Associations
- OSteoporosis
- AF
Treatment advised if TSH <0.1
(or if co-existing osteoporosis/ AF)
Non-thyroidal illness
Sick Euthyroid Syndrome
Commonly encountered in unwell, hospitalised patients
Refers to impact of recurrent illness on HPT axis
Sick Euthyroid Syndrome TSH
TSH typically surpassed initially then rises during recover
Avoid checking TFTs in unwell patients unless clinical suspicion of thyroid disease