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Transcript
Internal Medicine
Disease course: the thyroid pain and the hyperthyroidism subside in few weeks to months. The
gland usually return to normal size, if enlargement persists, chronic thyroiditis should be
suspected.
Diagnosis;
•
Acutely swollen, tender an painful thyroid gland associated with symptoms of
hyperthyroidism
•
Radioactive uptake: low radioactive iodine uptake in the face of high serum T3 and T4
level. This is because the follicles are damaged are unable to trap iodine.
Therapy is symptomatic: because the diseases are self limited
•
Aspirin , NSAID and Corticosteroids ( in severe cases ) to relive the pain and tenderness
•
β-blockers can be used to relive symptoms of hyperthyroidism .
Chronic Thyroiditis (Hashimoto thyroiditis)
Etiology: it is an autoimmune disorder that mainly affects women. Antithyriod antibodies are
present in most patients.
Clinical features
•
Thyroid gland enlargement: is the main clinical manifestation, is the result of
autoimmune damage that leads to lymphocytic infiltration, fibrosis and weakens ability of
the thyroid to produce hormone.
•
Pain and tenderness of the gland in subacute thyroiditis
•
Hypothyroidism is present in approximately 20 % of patients
Diagnosis: is suspected in any patient with firm, nontoxic goitre
•
Serology: high titer of antithyroglobulin antibodies, antimicrosomal antibodies
•
Thyroid function tests are often normal unless the patient has hypothyroidism
Therapy:
•
L-thyroxin often decreases the size of the gioter and it is useful even in patients with
normal thyroid function
Malignancies of the thyroid
Epidemiology:
•
Thyroid cancer is common; it is found at autopsy in approximately 5 % of patients with
no known thyroid diseases
471