The diagnosis focuses on.
1. goiter, acute and subacute often cause pressure symptoms, chronic is not painful.
2. Thyroid function is variable, commonly with inconsistent T4 and radioactive iodine uptake.
3. Anti-thyroid antibodies in the serum usually appear positive.
There are four types.
1. chronic lymphocytic thyroiditis, also known as Hashimoto’s (Hashimoto’s) thyroiditis, due to autoimmunity.
2. Subacute thyroiditis.
3.Septic thyroiditis.
4. Riedel’s thyroiditis.
Hashimoto’s thyroiditis]
It is the most common form of thyroiditis and probably the most common thyroid disease.
Symptoms.
Slowly enlarging, few signs of pressure, symmetrical enlargement of the thyroid gland, lobarization, no tenderness.
Antibody (anti-thyroglobulin antibodies and anti-granular glandular antibodies) concentrations are usually high.
It is more common in women, has a family history, and can occur at any age. Symptoms of abnormal thyroid function are common.
The symptoms are usually mild and go unnoticed. Anti-thyroid antibodies are found in up to 15% of hospitalized patients, with the majority having normal thyroid function.
Many patients become progressively hypothyroid, usually in combination with an enlarged thyroid gland.
Acute Hashimoto’s thyroiditis may, in rare cases, produce temporary hyperthyroidism.
Most patients with Gehrig’s disease will develop some degree of Hashimoto’s thyroiditis with high anti-thyroid antibodies.
Gehrig’s disease is distinguished from Hashimoto’s thyroid by the presence of anti-TSH antibodies (TSI).
Postpartum thyroiditis is a form of autoimmune thyroiditis combined with temporary hyperthyroidism, most of which recovers.
Comorbidities.
Hashimoto’s thyroiditis may lead to hypothyroidism.
It may be combined with Addison’s disease, parathyroidism, diabetes mellitus, pernicious anemia, biliary cirrhosis, leukoplakia and other autoimmune conditions.
Supervised diagnosis.
Antithyroid antibodies are helpful in the diagnosis of Hashimoto’s thyroiditis, but they are not specific and can be found in patients with goiter, cancer and thyrotoxicosis, although antibody concentrations are usually higher in Hashimoto’s thyroiditis. A biopsy may be needed to make the diagnosis.
Treatment.
If the thyroid is hypothyroid or the goiter is large, give Levothyroxine 0.1-0.15 mg daily.
If the thyroid is slightly enlarged and thyroid function and TSH values are normal, regular observation is sufficient, as hypothyroidism usually does not occur until several years later.