Goiter and Thyroid Nodules
Solitary thyroid nodules are the most common thyro...
Thyroiditis are infections of the thyroid gland.
Although it is not common, it is a pyogenic infectious disease caused by bacteria, characterized by sudden neck pain, dysphagia, fever and sweating. In the treatment of patients, high doses of antibiotics should be given, and if there is abscess formation, drainage should be performed.
1.Subacute granulomatous thyroiditis
It is an acute or subacute nonsuppurative inflammation of the thyroid gland. It is suggested that it is mostly viral in etiology, and there is evidence to support this.
The thyroid gland is completely or asymmetrically enlarged. Patients may experience sudden weakness, fever, pain in the area where the thyroid gland is located, difficulty in swallowing, and hoarseness. Palpitations, sweating, tremors and irritability occur due to temporary hyperthyroidism.
As laboratory findings, TSH level decreases with the increase in thyroid hormones in the blood, and high sedimentation is a characteristic finding. Scintigraphy and ultrasound help in diagnosis. The diagnosis of the disease is confirmed with IAB.
Salicylates (aspirin), nonsteroidal anti-inflammatory drugs, and in advanced cases, cortisone can be used in treatment. If there are hyperthyroidism findings, patients are given beta blockers.
2.Subacute lymphocytic (painless thyroiditis)
Subacute painless thyroiditis is a disease that progresses with transient thyrotoxicosis and is identified by zero scintigraphy.
Most patients have findings related to autoimmunity. They can be found together with some autoimmune diseases (Hashimoto, Addison, Sjögren's Send).
In the initial period, T4 and T3 concentrations increase due to the effect of hormones released from excessively fragmented follicles, and accordingly, TSH remains low. Antithyroglobulin antibodies are detected in 25% of patients and antithyroid peroxidase antibodies are detected in 60%. Thyroid functions may return to normal after 2-4 weeks. The hypothyroid period can last up to 10 weeks. Rarely, hypothyroidism becomes permanent.
There is no use of antithyroid medication in the treatment. Because the cause of hyperthyroidism is not the newly made hormone. Beta blockers are used when symptoms of hyperthyroidism bother the patient. Using anti-inflammatory drugs and cortisone reduces the symptoms of the disease.
Although there are two types of chronic thyroiditis: Hashimoto's thyroiditis (lymphocytic thyroiditis) and Riedel's thyroiditis (fibrous thyroiditis), chronic thyroiditis caused by specific infections (tuberculosis and syphilis) can be seen.
It is an autoimmune disease and the most common form of thyroiditis. Since it is an autoimmune disease, it is called chronic autoimmune thyroiditis.
HT thyroid gland is diffusely enlarged and hard.
HT is more common in middle-aged (30-50) women. Although the disease is mostly asymptomatic, some patients experience hypothyroidism symptoms such as goiter development, weakness, hair loss, and easy fatigue.
A connection between HT and thyroid cancer and lymphoma has been suggested by many researchers. This rate varies between 1-23%.
One of the most common causes of hypothyroidism is Hashimoto's thyroiditis. If serum thyroid hormone levels remain low and TSH levels remain high, hormone replacement should be performed. Hypothyroidism is detected in only 20% of patients with Hashimoto's.
The first treatment for Hashimoto's thyroiditis is medical. However, indications for surgical treatment are in special cases.
Thyroxine treatment should continue after surgery in patients with Hashimoto's thyroiditis. Most often, treatment continues for life. During long treatments, attention should be paid to osteoporosis, especially in women.
The disease was first described by Riedel in 1896. It is the least common form of thyroiditis.
The disease is three times more common in women. It is more common between the ages of 30-60.
Patients' thyroids appear to be very hard, stuck to the surrounding tissues, and look very similar to cancer.
Surgery has no place in the treatment of patients. However, when there are pressure symptoms and a diagnosis of cancer, surgical treatment should be chosen.