Presentation
[…] in 40-70% of individuals Provides no additional information over TRAb or TPO antibodies Hashimoto Thyroiditis Present in >90% of individuals Presence of antibody is pathognomonic for HT Not recommended for monitoring Not present Present in 60-80% of [arupconsult.com]
Antimicrosomal antibodies are present in 50 to 80 percent of patients, while antithyroid peroxidase antibodies are present in nearly all patients. 3, 6, 7 Subacute lymphocytic thyroiditis starts with an initial hyperthyroid phase, followed by subsequent [aafp.org]
EXAM: In most cases a small, nontender, firm goiter is present. [enotes.tripod.com]
Alexander Matthies, MD Nayer Nikpoor, MD April 8, 1997 Presentation A 38 year old female physician had right sided pain in the thyroid region for about 8 weeks and symptoms of hyperthyroidism for about 3 weeks prior to presentation. [med.harvard.edu]
The classic presentation of Graves disease include: 1. Hyperthyroidism 2. Goitre 3. Opthalmopathy 4. Dermopathy (unusual) 5. [sites.google.com]
Entire Body System
- Fatigue
This phase can be characterized by a slight enlargement of the thyroid gland and symptoms of weight gain, fatigue, lack of energy and often depression. [columbiasurgery.org]
• Findings of hyperthyroidism (weight loss, tachycardia, fatigue, etc.) • Diffuse, symmetrically enlarged, painless goiter approximately two to three times normal size is present in 90% of patients, while 10% have thyroid atrophy. [clinicaladvisor.com]
Case 28: Weight gain Case 29: Fatigue Case 3: Abdominal pain Case 30: Sore throat Case 31: Cough Case 32: Genital lesion Case 33: Headache Case 34: Vision loss Case 35: Heartburn Case 36: Fatigue Case 37: Skin changes Case 38: Ankle pain Case 39: Shoulder [amboss.com]
Symptoms: Symptoms may include the following: Fatigue. Muscle weakness Tremors (shaking hands or fingers). Unexpected weight gain. Constipation. Dry skin. Depression. Muscle aches. Weight loss. Nervousness, anxiety or irritability. [medigoo.com]
The most common symptoms include the following: fatigue, weight gain, pale or puffy face, feeling cold, joint and muscle pain, constipation, dry and thinning hair, heavy menstrual flow or irregular periods, depression, panic disorder, a slowed heart rate [en.wikipedia.org]
- Weight Gain
This phase can be characterized by a slight enlargement of the thyroid gland and symptoms of weight gain, fatigue, lack of energy and often depression. [columbiasurgery.org]
— less common • Asymptomatic goiter Physical • Findings of hypothyroidism (weight gain, facial puffiness, dry skin, hair loss, hoarseness, etc.) • Findings of hyperthyroidism (weight loss, tachycardia, fatigue, etc.) • Diffuse, symmetrically enlarged [clinicaladvisor.com]
The most common symptoms include the following: fatigue, weight gain, pale or puffy face, feeling cold, joint and muscle pain, constipation, dry and thinning hair, heavy menstrual flow or irregular periods, depression, panic disorder, a slowed heart rate [en.wikipedia.org]
Unexpected weight gain. Constipation. Dry skin. Depression. Muscle aches. Weight loss. Nervousness, anxiety or irritability. Difficulty sleeping. Rapid heart rate. [medigoo.com]
gain Case 29: Fatigue Case 3: Abdominal pain Case 30: Sore throat Case 31: Cough Case 32: Genital lesion Case 33: Headache Case 34: Vision loss Case 35: Heartburn Case 36: Fatigue Case 37: Skin changes Case 38: Ankle pain Case 39: Shoulder pain Case [amboss.com]
- Weakness
Subacute thyroiditis is manifested radiating pain in the neck, headache, General weakness, decreased physical activity and increased body temperature. [medicineinfo.net]
[…] biliary cirrhosis • Psychiatric disorders, such as depression, generalized anxiety disorder, or social phobia History • Symptoms of hypothyroidism (lethargy, constipation, cold intolerance) • Symptoms of hyperthyroidism (nervousness/anxiety, muscle weakness [clinicaladvisor.com]
Muscle weakness Tremors (shaking hands or fingers). Unexpected weight gain. Constipation. Dry skin. Depression. Muscle aches. Weight loss. Nervousness, anxiety or irritability. Difficulty sleeping. Rapid heart rate. [medigoo.com]
Subacute thyroiditis: a pain in the neck, extending to the occipital region, jaw, ears, temporal area, headache, weakness, decreased motor activity, increased body temperature. [medusanews.com]
There are reports that polymorphisms in the HLA locus, specifically the HLA-DR3 and HLA-DR5 alleles, are linked to Hashimoto thyroiditis, but the association is weak. [humpath.com]
- Falling
Serum total and free T 3 concentrations may not fall until the disease is far advanced, because increased serum thyrotropin concentrations stimulate the thyroid to release T 3. [enotes.tripod.com]
As hypothyroidism supervenes, T4 and T3 levels progressively fall, accompanied by a compensatory increase in TSH. [humpath.com]
Case 16: Trouble sleeping Case 17: Forgetfulness Case 18: Cough Case 19: Cough Case 2: Abdominal pain Case 20: Decreased sensation in extremities Case 21: Bloody urine Case 22: Problems with swallowing Case 23: Hearing loss Case 24: Evaluation after a fall [amboss.com]
Nevertheless, antibody-dependent cell-mediated cytotoxicity is a substantial factor behind the apoptotic fall-out of Hashimoto's thyroiditis. [en.wikipedia.org]
The average age of onset is 30 to 50 years. 7 The disorder tends to be geographical and seasonal, occurring most often in the summer and fall. 6, 7 CLINICAL MANIFESTATIONS Subacute granulomatous thyroiditis presents clinically with acute onset of pain [aafp.org]
- Myxedema
Seite 220 - Isolation and identification of the long acting thyroid stimulator and its relation to hyperthyroidism and circumscribed pretibial myxedema, J. Clin. Endocrinol. Metab., 24. 1005, 1964. 440. [books.google.de]
On gross examination, there is often presentation of a hard goiter that is not painful to the touch; [21] other symptoms seen with hypothyroidism, such as periorbital myxedema, depend on the current state of progression of the response, especially given [en.wikipedia.org]
Fibrous atrophy variant The gland is very small (1 to 6 g) and is characterized by abundant fibrous tissue, parenchymal atrophy and lymphoplasmacytic infiltration. 32,33 This variant is clinically associated with myxedema and a high incidence of Tg Abs [hormones.gr]
However the clinical spectrum may vary from myxedema to hyperthyroidism, rarely thyroid pain, steroid responsive encephalitis, post-partum pituitary failure, post-partum exacerbation, and multi-glandular autoimmune disease. [japanthyroid.jp]
Respiratoric
- Hoarseness
When the gland is large, signs of compression of the neck organs are revealed: hoarseness of the voice, difficulty in swallowing, breathing. Diagnostics Chronic fibroid thyroiditis is diagnosed by puncture biopsy. [en.detadoctor.com]
This compression produces the following symptoms: Hoarseness Difficulty swallowing (dysphagia) Choking Shortness of breath (dyspnoea) Eventually, as the normal thyroid tissue is replaced by fibrous scar tissue, there is insufficient functioning tissue [thyroid.com.au]
— less common • Asymptomatic goiter Physical • Findings of hypothyroidism (weight gain, facial puffiness, dry skin, hair loss, hoarseness, etc.) • Findings of hyperthyroidism (weight loss, tachycardia, fatigue, etc.) • Diffuse, symmetrically enlarged [clinicaladvisor.com]
[…] or conditions Signs and Symptoms Hashimoto's: Firm, symmetrically enlarged, lobulated gland not tender on palpation; few pressure symptoms Progressive worsening of hypothyroid symptoms—cool, dry skin, slow pulse rate (60 bpm), swelling around eyes, hoarseness [syrianclinic.com]
For large scale cancer symptoms of compression of the neck: hoarseness, difficulty swallowing and breathing. Autoimmune chronic thyroiditis: in the first years of illness complaints and symptoms are usually absent. [medusanews.com]
Skin
- Dry Skin
[…] lethargy, constipation, cold intolerance) • Symptoms of hyperthyroidism (nervousness/anxiety, muscle weakness, diarrhea, heat intolerance, etc.) — less common • Asymptomatic goiter Physical • Findings of hypothyroidism (weight gain, facial puffiness, dry [clinicaladvisor.com]
Dry skin. Depression. Muscle aches. Weight loss. Nervousness, anxiety or irritability. Difficulty sleeping. Rapid heart rate. [medigoo.com]
In the long may develop symptoms of hypothyroidism (hypothyroid phase), drowsiness, lethargy, confusion, sensitivity to cold, swelling of the face, dry skin, slowing of heart rate, constipation. [medusanews.com]
Positive family history or preceding autoimmune diseases or conditions Signs and Symptoms Hashimoto's: Firm, symmetrically enlarged, lobulated gland not tender on palpation; few pressure symptoms Progressive worsening of hypothyroid symptoms—cool, dry [syrianclinic.com]
Workup
(See Etiology and Workup.) Gross pathology of Riedel thyroiditis. The cut edge is avascular, with a characteristic white color. Image courtesy of SL Lee. Involvement in RT may be unilateral or bilobar. [emedicine.medscape.com]
^ "Hashimoto Thyroiditis Workup: Approach Considerations, Serum TSH Test and Other Studies, Ultrasonography". emedicine.medscape.com. Retrieved 4 December 2017. ^ "Prasad's syndrome" (PDF). [en.wikipedia.org]
Treatment
Make the best clinical decisions with an enhanced emphasis on evidence-based practice and expert opinions on treatment strategies. Zero in on the most relevant and useful references with the aid of a more focused, concise bibliography. [books.google.com]
Rapidly consult with trusted authorities thanks to new expert-opinion treatment strategies and recommendations. Zero in on the most relevant and useful references with the aid of a more focused, concise bibliography. [books.google.de]
Radiation-induced thyroiditis is caused by radiation treatment that is given for the treatment of cancer or radioactive iodine treatment. Sometime even taking certain drugs causes thyroiditis. [medigoo.com]
Treatment should begin as early as possible in order to avoid complications. [medusanews.com]
Treatment Replacement therapy with thyroid hormones is prescribed as treatment, and for symptoms of compression of the neck organs, surgical treatment is prescribed. [en.detadoctor.com]
Prognosis
In the same study, the mean age at diagnosis of RT was 47.8 years (range, 23-77 y). [3] Prognosis Riedel thyroiditis (RT) is generally a self-limited disease with a favorable prognosis. [emedicine.medscape.com]
Prognosis • Presence of serum antithyroid antibodies associated with increased risk for future development of hypothyroidism • Patients with subclinical Hashimoto thyroiditis may progress to overt hypothyroidism at a rate of Treatment • Treatment for [clinicaladvisor.com]
Prognosis depends on the extent of extracervical fibrosclerosis. [link.springer.com]
Prognosis Some degree of compromise or disability is expected for 6 to 12 months: hyperthyroid phase, 1 to 3 months; hypothyroid phase, 3 to 6 months, then gradual return to euthyroid. [syrianclinic.com]
It is frequently afflicted by cancer ... but the common cancer has such a good prognosis there is debate about how aggressively it should be treated. The cytopathology of the thyroid gland is dealt with in the thyroid cytology article. [librepathology.org]
Etiology
Etiology and pathogeny. The disease etiology not ustanovlena-Hronichesky inflammatory process in a thyroid gland is followed by primary growth of connecting is woven its germination in a capsule and surrounding fabrics. [infomeds.net]
TERMINOLOGY Abbreviations Riedel thyroiditis (RT) Synonyms Invasive fibrous thyroiditis Ligneous thyroiditis Definitions Idiopathic fibrosing process Not per se an inflammatory thyroid disease (thyroiditis) of thyroid gland ETIOLOGY/PATHOGENESIS Autoimmune [basicmedicalkey.com]
Abstract The authors present the case of a 42-year-old female patient, initially admitted to hospital for the etiological diagnosis--which remained negative--and the treatment of a superior vena cava syndrome. [ncbi.nlm.nih.gov]
However, IgG4-RSD may unify these 2 seemingly disparate etiologies. [emedicine.medscape.com]
Introduction: Inflammatory disorders of thyroid gland are a mixture of various disorders characterized by variable clinical presentations, etiologies and treatment modalities. [sites.google.com]
Epidemiology
[…] tract, parotid gland, lacrimal gland, hepatobiliary tract (sclerosing cholangitis) RT may coexist with one or more of these other sites of involvement Only retroperitoneal fibrosis linked to possible etiologic agent (i.e., methysergide) CLINICAL ISSUES Epidemiology [basicmedicalkey.com]
Epidemiologic studies have demonstrated a significant genetic component to Hashimoto thyroiditis, although, as in most other autoimmune disorders, the pattern of inheritance is non-Mendelian and likely to be influenced by subtle variations in the functions [humpath.com]
EPIDEMIOLOGY Women are three to five times more likely to be affected than men. [aafp.org]
The disorders are characterized by lymphoplasmacytic infiltrates containing IgG4-positive plasma cells. [5] These infiltrates ultimately lead to fibrosis and elevated serum levels of IgG4. [6, 7] Epidemiology United States Riedel thyroiditis (RT) is a [emedicine.medscape.com]
[…] intracranial pressure and brain herniation Elimination disorders Embryogenesis Emotional and behavioral disorders in children and adolescents Endarterectomy Endometrial cancer Endometriosis Endophthalmitis Environmental injuries Enzymes and biocatalysis Epidemiology [amboss.com]
Pathophysiology
The hallmarks of the disease are fibrosis and infiltration by IgG4 secreting plasma cells. [1] Pathophysiology [ edit ] Riedel's thyroiditis is characterized by a replacement of the normal thyroid parenchyma by a dense fibrosis that invades adjacent structures [en.wikipedia.org]
[…] titers in Hashimoto's; possible in other types Erythrocyte sedimentation rate: elevated in subacute; markedly elevated in silent Biopsy: only if antibodies not detected and no apparent cause for symptoms; see giant cells in silent thyroiditis Pathology/Pathophysiology [syrianclinic.com]
Although IgG4-related Hashimoto’s thyroiditis and Riedel’s thyroiditis are two distinct entities, they share the pathophysiology of IgG4-related disease. [nature.com]
Resources Thyroid Disease Manager is an online, regularly updated resource that includes chapters on all aspects of thyroid disorders from pathophysiology through to management: www.thyroidmanager.org The American Thyroid Association provides clinical [racgp.org.au]
Prevention
Rapidly find the answers you need with separate sections on diseases and disorders, differential diagnosis, clinical algorithms, laboratory results, and clinical preventive services, plus an at-a-glance format that uses cross-references, outlines, bullets [books.google.de]
0% Emergent - ED Care Needed - Preventable/Avoidable - 0% Emergent - ED Care Needed - Not Preventable/Avoidable - 0% Primary diagnosis of injury 0% Primary diagnosis of mental health problems 0% Primary diagnosis of substance abuse 0% Primary diagnosis [medicbind.com]
Screening and prevention in pregnancy • Selenomethionine treatment during and after pregnancy may prevent postpartum thyroid dysfunction. • Women with a history of autoimmune thyroiditis should be monitored during and after pregnancy for disease progression [clinicaladvisor.com]
Some patients are able to retain sufficient thyroid reserve to prevent hypothyroidism. Silent thyroiditis is also a typically a temporary condition with only a slight enlargement of the thyroid gland. [medigoo.com]