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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
Acutely swollen, tender an painful thyroid gland associated with symptoms of
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
L-thyroxin often decreases the size of the gioter and it is useful even in patients with
normal thyroid function
Malignancies of the thyroid
Thyroid cancer is common; it is found at autopsy in approximately 5 % of patients with
no known thyroid diseases