10 THYROIDITIS
Inflammatory
disease of the thyroid occurs in four different varieties:
10.1 Septic or suppurative thyroiditis
is due to sterepto or staphylococcus infected and is extremely rare
10.2 de Quervain’s thyroiditis, also
known as subacute or granulomatous thyroiditis is most likely due to a viral
infection. The onset is usually acute following a throat infection. The ESR is
raised but there is no rise of WBC
10.2.1 Treatment is with aspirin in
some cases. Predinisolone 5-10mg a day will be required
10.3 Autoimmune or lymphocytic
thyroiditis (Hashimoto’s). The thyroid is moderately enlarged non-tender and
has a firm lobulated surface, it may progress to hypothyroidism. Thyroid
antibodies (TRC, TMA) are demonstrable. Cytology can be of help in diagnosis.
10.3.1 Treatment is with replacement of
thyroid hormones for hypothyroidism
10.4 Reidels thyroiditis is
characterised by an overgrowth of fibrous tissue and presents with a hard
(woody thyroid) gland. Its presentation is like a carcinoma and a biopsy is the
only means of diagnosis
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