Thyroiditis

Question 1

Define thyroiditis ?

Answer 1

inflammation of the thyroid gland.

Question 2

most common thyroiditis?

Answer 2

• Hashimoto’s thyroiditis

Question 3

pathogenesis of hashimotos?

Answer 3

o Aggressive destruction of thyroid cells by the immune system
o Environmental triggers have been hypothesised

Question 4

what are the other types of thyroiditis?

Answer 4

o	De Quervain's thyroiditis
o	Postpartum thyroiditis  
o	Drug-induced thyroiditis  
o	Acute or infectious thyroiditis  
o	Riedel's thyroiditis

Question 5

features of De Quervain’s thyroiditis?

Answer 5

• Subacute thyroiditis
• Presents post viral infection
• Presents initially with hyperthyroidism
• Elevated ESR
• Painful goitre

Question 6

features of Postpartum thyroiditis ?

Answer 6

• presents with hyperthyroidism
• occurs post partum
• Diagnosis made with TFTs
• Thyroid peroxidase antibodies are very common
• Should be managed with propranolol

Question 7

what drugs cause drug induced thyroiditis?

Answer 7

• amiodarone

- lithium

Question 8

amongst whom is infective thyroiditis common?

Answer 8

• Common amongst children

Question 9

what is the pathophysiology of riedels?

Answer 9

• Dense fibrous tissue replaces normal thyroid tissue

Question 10

what is the epidemiology of thyroiditis?

Answer 10

• True incidence is UNKNOWN
• 15-20 x more common in WOMEN
• Usually occurs in 30-50 yrs

Question 11

presenting symptoms of hashimotos thyroiditis?

Answer 11

• Hashimoto’s presents with hypothyroidism + goitre + anti-TPO

Question 12

symptoms of hypothyroidism?

Answer 12

o	Fatigue  
o	Constipation  
o	Dry skin  
o	Weight gain  
o	Cold intolerance  
o	Menstrual irregularities  
o	Depression  
o	Hair loss

Question 13

symptoms caused by enlarged thyroid?

Answer 13

o Dyspnoea
o Dysphagia
o Tenderness

Question 14

investigations for thyroiditis?

Answer 14

•	TSH 
•	Antibodies: 
o	Anti-TPO antibodies  (post partum and hashimotos) 
o	Anti-thyroglobulin antibodies  
•	Thyroid ultrasound  
•	Radionuclide isotope scanning

Question 15

management for thyroiditis?

Answer 15

o Thyroid hormone replacement - oral levothyroxine sodium

• Surgical considered if there is a large goitre

Question 16

complications of thyroiditis?

Answer 16

• Thyroid hormone over-replacement –> bone loss + tachycardia
• Hyperlipidaemia
• Hashimoto’s encephalopathy
• Myxoedema coma

Question 17

prognosis of thyroiditis?

Answer 17

• GOOD PROGNOSIS