Thyroiditis and Subacute Thyroid Disease Flashcards
Subacute thyroiditis is most common in who?
Females, aged 20-50
What is the most common trigger of subacute thyroiditis? What symptoms may this cause?
Viral infection- painful neck, fever
What scan can be performed to help diagnose subacute thyroiditis?
Scintigraphy scan
What will a scintigraphy scan show in subacute thyroiditis?
Low uptake throughout
What is usually the origin of DeQuervain’s thyroiditis?
Viral infection
How does DeQuervain’s thyroiditis usually present? What may precede it?
Painful goitre with a preceding upper respiratory tract infection
What type of inflammation is involved in DeQuervain’s thyroiditis?
Granulomatous
How would you describe the goitre in subacute lymphocytic thyroiditis?
Small and painless
What are the different phases in subacute lymphocytic thyroiditis?
Hyperthyroid, euthyroid, hypothyroid, euthyroid
How is subacute lymphocytic thyroiditis diagnosed?
Iodine uptake scan
What is a variant of subacute lymphocytic thyroiditis?
Post-partum thyroiditis
Subacute lymphocytic thyroiditis (and post-partum thyroiditis) and considered subtypes of precursors of what?
Hashimoto’s thyroiditis
Which is autoimmune- DeQuervain’s thyroiditis or subacute lymphocytic thyroiditis?
Subacute lymphocytic thyroiditis
Amiodarone inhibits what? This has what effect on TFTs?
DI01- Increased T4, Decreased T3, Normal TSH
TFTs are abnormal in what % of patients on amiodarone?
50%
Is it more common for patients to be hypo or hyperthyroid on amiodarone?
Hypothyroid
What is the relation between amiodarone causing hypothyroid and iodine?
Amiodarone causes hypothyroid in areas which are iodine rich
What is the relation between amiodarone causing hyperthyroid and iodine?
Amiodarone causes hyperthyroid in areas which are iodine deficient
How is subacute thyroid disease described?
Abnormal TSH with normal thyroid hormone levels
What will TFTs show in subclinical hypothyroidism?
- Increased TSH with normal T3/4
Is there a risk of subclinical thyroid disease becoming overt?
Yes
What increases the risk of progression from subclinical hypothyroidism to hypothyroidism?
If the patient is highly anti-TPO antibody positive
When should subclinical hypothyroid be treated?
If TSH > 10 or the patient is pregnant
What will TFTs show in subclinical hyperthyroidism?
- Decreased TSH and normal T3/4
Subclinical hyperthyroidism is most likely to progress to what?
Toxic multi nodular goitre
There is often an association between subclinical hyperthyroidism and what other two diseases?
AF and osteoporosis
When should subclinical hyperthyroid be treated?
If AF or osteoporosis are present, or if TSH < 0.1
When is sick euthyroid syndrome encountered? Why?
Sick, hospitalised patients because their current illness has interfered with the HPT axis
What will happen to TSH levels during sick euthyroid syndrome?
They will be suppressed initially and then rise during recovery
Should TFTs be performed in acutely unwell patients?
No (not unless there is clinical suspicion of an underlying thyroid disease)
