Thyroiditis
Summary/Definition
Thyroiditis is a disease-causing inflammation of the thyroid gland, the symptom of which is fever and pain in the area of the enlarged thyroid gland when touched. The disease manifests itself in various forms. There are various causes of thyroiditis, including autoimmune reactions to thyroid antibodies, viral and bacterial infections, medication and external radiation therapy. The autoimmune reaction is a failure of the immune system in which antibodies, perceiving the body’s cells as foreign, begin to attack and destroy them.
<Table1. Causes and features of thyroiditis>
| Types of inflammation | Causes | Symptoms | Characteristics |
| Autoimmune thyroiditis (Hashimoto’s thyroiditis) | autoimmune reaction | – patients have no special complaints; – thyroid function is normal; – hypothyroidism occasionally occurs. | – is the most common type of thyroiditis; – more common in middle-aged women; – The thyroid is enlarged and masses (nodules) are present. |
| Subacute thyroiditis | virus infection | – flu-like symptoms; – the thyroid is enlarged, there’s pain; – symptoms of thyrotoxicosis appear early on; – in most cases, the symptoms disappear on their own after 1-2 months. | – is after the patient has had upper respiratory tract infections such as acute respiratory infections, colds with fever, etc.; – most patients recover after basic treatment; – treatment depends on the symptoms experienced. |
| Asymptomatic (painless) thyroiditis | autoimmune reaction | – short-term thyrotoxicosis in the early phase; – in most cases recover on their own, and in some cases, the reaction starts with a hyperthyroid phase. | – no painful sensations in the thyroid gland; – no symptoms of acute respiratory infections or body aches at the onset of the disease. |
| Postpartum thyroiditis | autoimmune reaction | – develops about 2-3 months after childbirth in women; – the thyroid is enlarged, moderate signs of hypothyroidism; – normalization of the condition occurs after some time. | – most women recover naturally; – is found in about 5-10% of women who have given birth. |
| Drug and radiation thyroiditis | drug side effects and radiation exposure | – is caused by the destruction of the thyroid due to medications and radiation exposure; – interferon, amiodarone, lithium drugs, radioactive iodine and radiation can cause. | – normalization of the condition occurs on its own in most cases, when the drug causing the condition is discontinued. |
| Acute bacterial (infectious) thyroiditis | bacteria, moulds | – the main symptoms caused by a bacterial infection; – pain in the thyroid; – symptoms of hypothyroidism, and hyperthyroidism occur. | – after treatment of the infection, against the background of the disease, there is normalization of the patient’s condition, symptoms disappear on their own. |
Symptoms
When the thyroid gland is inflamed at an early stage, patients are not particularly bothered by anything, but in most cases, the main symptoms of hypothyroidism appear immediately, such as chills, a feeling of chilliness, weight gain, dry skin, rapid fatigue and fatigue of the body. With the intensification and development of inflammatory processes in the thyroid gland, symptoms of hyperthyroidism appear palpitations, tachycardia, fatigue, tremors of the hands and increased sweating. In most cases, there is no soreness or pain when palpating the thyroid gland, but if it increases in size, it may feel like it is pressing on surrounding areas.
Diagnostics
When making a diagnosis, clinical aspects such as the patient’s medical history, symptoms and signs of the disease are studied, and diagnostic tests are carried out (blood tests, thyroperoxidase antibody tests, tests to determine the degree of thyroperoxidase inflammation, etc.). There are some cases where ultrasound, scintigraphy, radioactive iodine uptake tests, etc. are required.
Treatment and course of the disease
Thyroiditis resulting from drugs or radiation therapy can be cured by complete withdrawal of the drug or discontinuation of radiation therapy. Acute thyroiditis caused by bacterial infection can also be treated by eliminating the causative bacteria, antibiotics, and, if necessary, surgery. In the case of subacute thyroiditis, the main treatment aims to control the symptoms of the patient, which does not require special treatment, i.e. the treatment is carried out depending on the thyroid dysfunction detected in the individual case. In the case of autoimmune diseases, such as Hashimoto’s thyroiditis, there are no fundamental treatment options, and treatment is adjusted depending on the patient’s condition and the identified symptoms of inflammation. In hyperthyroidism, antithyroid drugs are prescribed to reduce thyroid hormone levels, and in hypothyroidism, thyroid hormone preparations are prescribed to normalise hormone levels.
