THYROIDITIS
[i] Acute Thyroiditis:
Pyogenic infection.
Complication of infectious fever.
Thyroid is hot, red & tender, if pus is formed it may point to skin or deep to trachea or pharynx.
Treatment: Antibiotics, fomentation, drainage of pus if needed.
[ii] Subacute Thyroiditis (de Quervain's disease):
Viral infection (Influenza or Mumps).
Sudden onset but subsides spontaneously in 3 months..
Usually affect middle aged female .
The gland is hot, red, tender, painful with fever.
Scintillation scanning and radioactive iodine uptake show hypofunction thyroid while there is mild thyrotoxicosis due to destruction of the follicles.
Treatment:
Cortisone 10 mg daily for one month gives dramatic response.
[iii] Chronic Thyroiditis:
Two varieties of unknown aetiology, the pathology of them is the same with clinical difference.
A) Hashimoto's Disease (Lymphadenoid goitre)
More common than Riedel's disease.
Affect menopausal women.
Considered as an auto immune dis. against patient's thyroglobulin.
The gland is lobulated (Not nodular) of moderate size.
Hypothyroidism with no pressure symptoms.
Treatment:L. thyroxine with cortisone.
Radiation gives good results but myxedema occurs.
B) Riedel's Disease (Ligneous thyroiditis):
Very rare. Affect young adults of both sexes.
The gland is slightly enlarged but very hard (woody).
Pressure symptoms on trachea is marked.
No hypothyroidism inspite of marked fibrosis.
Treatment:
Thyroidectomy is impossible, radiotherapy is ineffective.
Resection of thyroid isthmus is the ttt of choice.
SOURCE: Prof. AYMAN SALEM'S BOOK
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