This book describes Thyroiditis, Diagnosis and Treatment and Related Diseases
The term thyroiditis indicates inflammation of the thyroid gland.
Thyroiditis can be classified based on the start of symptoms, underlying cause and medical symptoms.
The most frequent cause of thyroiditis is an autoimmune disease.
Thyroiditis can cause temporary or permanent hypothyroidism and hyperthyroidism
Thyrotoxic phase
Thyrotoxicosis indicates that the thyroid is inflamed and secretes too many hormones.
Hypothyroid phase
After the excessive secretion of thyroid hormones for a few weeks or months, the thyroid will not have sufficient thyroid hormones to release.
This causes a lack of thyroid hormones or hypothyroidism.
Euthyroid phase
During the final euthyroid phase, the thyroid hormone levels return to normal.
This phase may come transiently after the thyrotoxic phase before continuing to the hypothyroid phase, or it may terminate after the thyroid gland has healed from the inflammation and is able to maintain a normal hormone level.
Types of thyroiditis
Hashimoto's thyroiditis: an autoimmune disorder produced by anti-thyroid antibodies.
This is the most frequent type of thyroiditis and 5 times more frequent in women than in men.
Hashimoto's thyroiditis normally leads to hypothyroidism, and thyroid hormone replacement treatment is required.
Silent thyroiditis or painless thyroiditis: another autoimmune disease produced by anti-thyroid antibodies.
It is also frequent in women and the next frequent cause after Hashimoto's thyroiditis.
Post-partum thyroiditis: an autoimmune disorder produced by anti-thyroid antibodies that occasionally happens shortly after a woman gives birth
Radiation-induced thyroiditis: a disorder produced by external radiation used as a medical treatment for certain cancers, or by radioactive iodine used to treat hyperthyroidism
Sub-acute thyroiditis or de Quervain's thyroiditis: an often painful disorder believed to be produced by a virus
Acute thyroiditis or suppurative thyroiditis: a relatively rare disorder produced by an infectious organism or bacterium
Drug-induced thyroiditis: a disorder is produced by the use of drugs such as amiodarone, interferons, lithium, and cytokines.
Thyroiditis can happen due to:
Autoimmune disease (Hashimoto thyroiditis, Graves disease, postpartum thyroiditis or painless sporadic thyroiditis),
Infection (painful sub-acute thyroiditis or suppurative thyroiditis),
Drugs (amiodarone, lithium, interferons and interleukin-2; and checkpoint inhibitors) or
Fibrosis (Riedel thyroiditis)
It can be categorized into acute, sub-acute, and chronic thyroiditis.
Acute thyroiditis is produced by bacterial infection of the gland.
Sub-acute, also termed granulomatous thyroiditis, is produced by viruses.
Chronic involves autoimmune thyroiditis, Hashimoto thyroiditis, postpartum thyroiditis, and other painless thyroiditis, such as iatrogenic and drug-induced thyroiditis.
Thyroid-stimulating hormone (TSH) should be examined to see if the patient has hyperthyroidism or hypothyroidism.
Thyroid microsomal antibodies and thyroid receptor antibodies can be examined for confirmation of autoimmune thyroid disease.
Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) are raised in infectious thyroiditis (bacterial).
Thyroid ultrasound is the most important and most often used imaging method for evaluation of the thyroid gland.
The treatment of thyroiditis is dependent on the type, symptoms, and phase of thyroiditis.