(Thyroiditis de Quervain, giant cell – or granulomatous thyroiditis)

Subacute thyroiditis is inflammation of the thyroid gland, which is believed to be caused by a virus. Symptoms include fever and sensitivity of the thyroid gland. Initial hyperthyroidism is common, sometimes followed by a transition period of hypothyroidism. The diagnosis is made clinically and by laboratory tests. Treatment is with high doses NSAIDs or corticosteroids. The disease usually goes away within a few months by itself.

Subacute thyroiditis is inflammation of the thyroid gland, which is believed to be caused by a virus. Symptoms include fever and sensitivity of the thyroid gland. Initial hyperthyroidism is common, sometimes followed by a transition period of hypothyroidism. The diagnosis is made clinically and by laboratory tests. Treatment is with high doses NSAIDs or corticosteroids. The disease usually goes away within a few months by itself.

(See illustration of the thyroid function.) The subacute thyroiditis is inflammation of the thyroid gland, which is believed to be caused by a virus. Symptoms include fever and sensitivity of the thyroid gland. Initial hyperthyroidism is common, sometimes followed by a transition period of hypothyroidism. The diagnosis is made clinically and by laboratory tests. Treatment is with high doses NSAIDs or corticosteroids. The disease usually goes away within a few months by itself. A history is often a previous viral infection of the upper respiratory tract. Histologically less lymphocytic infiltration of the thyroid gland than in Hashimoto’s thyroiditis or latent lymphocytic thyroiditis shows. But it show up characteristic giant cells, polymorphonuclear lymphocytes and a disintegration of the follicle. Symptoms and signs There is pain in the front of the neck and an increased body temperature from 37.8 to 38.3 ° C. Change the sore throat usually from side to side and radiate into the jaw and ears out. The pain is often attributed to an infected tooth, pharyngitis or otitis and aggravated by swallowing or turning the head. Symptoms of hyperthyroidism occur in the early stage of the disease on by the hormone release from decaying follicles. A stronger exhaustion and fatigue than other thyroid disease is striking. On physical examination, the thyroid is u. U. unilaterally enlarged and painful. Diagnosis Clinical findings determine the levels of free thyroxine (T4) and thyroid-stimulating hormone (TSH) BSG Radioactive iodine uptake The diagnosis is clinically primarily based on the findings of a scaled-sensitive thyroid in patients with appropriate clinical history. There is usually a thyroid examination with TSH and a measurement of free T4 levels. To confirm the diagnosis, the radioactive iodine uptake should be measured (Editor’s note: After performing a thyroid sonography with typical result is in Germany often dispensed with thyroid scintigraphy). In an uncertain diagnosis fine needle aspiration biopsy is useful. An ultrasound of the thyroid with color Doppler shows multiple irregular “sonolucent” areas and a reduced blood flow in contrast to the increased flow in Graves’ disease. The laboratory values ??in the early phase of the disease show an increase of free T4 and triiodothyronine (T3), a substantial TSH waste and significantly decreased uptake of radioactive iodine (odt 0) and high ESR. After a few weeks the memory of T4 and T3 are empty and a temporary hypothyroidism develops which is accompanied by a drop in the free T4 and T3, an increase of TSH and the normalization of thyroid Nuklidaufnahme. Weak positive antibodies against the thyroid gland may occur. Measurement of free T4, T3, and TSH at 2 – to 4-week intervals show the stages of the disease. Prognosis The subacute thyroiditis runs self-limiting and resolves within a few months. Occasionally relapse, which can lead to permanent hypothyroidism in severe destruction of the follicle. NSAIDs therapy Sometimes corticosteroids, a beta-blocker, or both discomfort is treated with high doses of aspirin or NSAIDs. In severe and prolonged cases, corticosteroids remedy (eg. Prednisone 15-30 mg po 1 times a day, gradually reducing the dose over 3-4 weeks) h all symptoms within 48. Annoying hyperthyroid symptoms can be treated with a short cycle of beta-blockers. If hypothyroidism is pronounced or persists, a substitution therapy may be necessary rarely permanent. Conclusion manifestations are usually fever, neck pain and an enlarged pressure-sensitive thyroid. Patients are initially hyperthyroid, low TSH level and increased levels of free T4. Sometimes they are then hypothyroid phases. The TSH value is then increased, the lowering of free T4. The treatment is with NSAIDs plus. Sometimes corticosteroids and / or beta blockers.

Health Life Media Team

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