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Thyroiditis

Definition: The inflammation of the thyroid gland Types of thyroiditis Acute thyroiditis Definition: Is a rare disorder caused by infection of the thyroid gland by bacteria, fungi, mycobacteria, or parasites Causes: Staphylococcus aureus are the most common S & Sx: Anterior neck pain and swelling, fever, dysphagia, dysphonia, pharyngitis, or pharyngeal pain Examination: Reveals warmth, erythema (redness), and tenderness of the thyroid gland Treatment: Antimicrobial agents and fluid replacement, surgical incision and drainage may be needed if an abscess is present Subacute Thyroiditis Definition: May be of two kinds: Subacute granulomatous thyroiditis and painless thyroiditis Subacute Granulomatous Thyroiditis Definition: Is an inflammatory disorder of the thyroid gland that predominantly affects women between 40-50 ages of years. It is also associated with a viral respiratory infection and has a summer peak incidence that coincides with coxsackievirus groups A and B and echovirus infections. Causes: Virus S & Sx: Myalgias, pharyngitis, low-grade fever, and fatigue, painful swelling at the anterior neck, symmetric enlargement of the thyroid, difficulty of swallowing Treatment: NSAIDs to relieve neck pain, Acetylsalicylic acid (aspirin) is avoided if Sx of hyperthyroidism occur, oral corticosteroids, follow up monitoring Painless thyroiditis (Subacute Lymphocytic Thyroiditis) Definition: Often occurs in the postpartum period and is thought to be an autoimmune process

S & Sx: Sx of hyperthyroidism and hypothyroidism Treatment: Directed at symptoms, and a yearly follow-up is recommended Chronic Thyroiditis Definition: Also known as Hashimotos disease or chronic lymphocytic thyroiditis, it occurs most frequently in women between 30-50 ages of years Cell mediated immunity may play a significant role in the pathogenesis of chronic thyroiditis and there may be a genetic predisposition to it. Cause: Unknown S & Sx: initially the Sx of hyperthyroidism, such as restlessness, tremors, chest pain, increased appetite, diarrhea, moist skin, heat intolerance, and weight loss. Diagnostic tests: Immunofluorescent assay, a test that detects antigens on cells using an antibody with a fluorescent tag, detects antithyroid antibodies. TSH is elevated, while (T3) and (T4) levels are low. A thyroid scan is also done. Treatment: The objective is to reduce the size of the thyroid gland and the prevent hypothyroidism, thyroid hormone therapy