Thyroiditis

Year 2012, Volume: 29 Issue: 4S, 321 - 327, 07.05.2013

Gülçin Cengiz Ecemiş Ramis Çolak

https://doi.org/10.5835/jecm.omu.29.s4.020

Abstract

Thyroiditis is an inflammation of the thyroid gland that may be painful and tender when caused by infection, radiation, or trauma, or painless when caused by autoimmune conditions, medications, or an idiopathic fibrotic process. The most common forms are Hashimoto’s disease, subacute granulomatous thyroiditis, postpartum thyroiditis, subacute lymphocytic thyroiditis, and drug-induced thyroiditis (caused by amiodarone, interferon-alfa, interleukin-2, or lithium). Patients may have euthyroidism, hyperthyroidism, or hypothyroidism. Diagnosis is by clinical findings, including the presence or absence of pain, tenderness, and autoantibodies. Treatment primarily is directed at symptomatic relief of thyroid pain and tenderness and restoration of euthyroidism. In this article we review the diagnosis and treatment of the different types of thyroiditis.

Keywords

Thyroiditis, Chronic lymphocytic thyroiditis, Subacute lymphocytic thyroiditis, Acute thyroiditis, Subacute granulomatous thyroiditis, Riedel

Tiroiditler

Abstract

Tiroit bezinin inflamasyonu sonucu oluşan tiroiditler enfeksiyon, radyasyon ve travma ile olduğunda ağrılı ve hassas, otoimmün olaylara, ilaçlara ve idopatik fibrotik sürece bağlı olduğunda ağrısız olurlar. En yaygın formları; Hashimoto hastalığı, subakut granülomatöz tiroidit, postpartum tiroidit, subakut lenfositik tiroidit ve ilaca bağlı (amiodaron, interferon alfa, interlökin-2, lityum) tiroiditlerdir. Hastalar ötiroit, hipertiroit veya hipotiroit olabilirler. Tanı ağrı ve hassasiyeti içeren klinik bulgular ve otoantikorlar ile konur. Tedavi esas olarak tiroit ağrı ve hassasiyetindeki semptomatik iyileşmenin ve ötiroidizmin sağlanmasıdır. Bu yazıda çeşitli tiroidit tiplerinin tanı ve tedavisini gözden geçirdik.

Keywords

Tiroiditler, Kronik lenfositik tiroidit, Subakut lenfositik tiroidit, Akut tiroidit, Subakut granülamatöz tiroidit, Riedel tiroiditi

References

• Bahn, RS., Burch, H.B., Cooper, D.S., Garber, J.R., Greenlee, M.C., Klein, I., Laurberg, P., McDougall, I.R., Montori, V.M., Rivkees, S.A., Ross, D.S., Sosa, J.A., Stan, M.N., 2011. American Thyroid Association; American Association of Clinical Endocrinologists. Hyperthyroid- ism and other causes of thyrotoxicosis: Management guidelines of the American Thyroid Association and American Association of Clinical Endocrinologists. Thyroid. 21, 593-646.
• Brent, G.A., Larsen, P.R., Davies, T.F., 2008. Hypothroidism and Thyroiditis. In: Williams Textbook of Endocrinology. Kronenberg, H.M., Melmed, Shlomo., Polonsky, K.S., Larsen, P.R., ed. Saunders Elsevier , Philadelphia. 377-409
• Bindra, A., Braunstein, G.D., 2006. Thyroiditis. Am. Fam. Physician. 73,1769-1776.
• Cohen-Lehman, J., Dahl, P., Danzi, S., Klein, I., 2010. Effects of amiodarone therapy in thyroid function. Nat. Rev. Endocrinol. 6, 34-41.
• Cooper, D.S., Greenspan, F.C., Ladenson, P.W., 2007. The Thyroid Gland. In: Greenspan’s Basic and Clinical Endocrinology. Gardner D.G., Shoback D., ed. The McGraw-Hill Companies, U.S.A. 209-280.
• Eskes, S.A., Wiersinga, W.M., 2009. Amiodarone and thyroid. Best Pract. Res. Cl. En. 23, 735-751.
• Fatourechi, V., Aniszewski, J.P., Fatourechi, G.Z., Atkinson, E.J., Jacobsen S.J., 2003. Clinical features and outcome of subacute thyroiditis in an incidence cohort: Olmsted county, Minnesota, study. J. Clin. Endocr. Metab. 88, 2100-2105.
• Gardner, D.G., 2007. Endocrine emergencies. In: Greenspan’s Basic and Clinical Endocrinology. Gardner DG., Shoback D., ed. The McGraw- Hill Companies U.S.A. 868-893.
• Güllü, S., 2011. Tiroiditler. Endokrinoloji Metabolizma ve Diyabet. İçinde: Özata M., ed. İstanbul Tıp Kitabevi Yayıncılık, İstanbul.165-176.
• Iitaka, M., Momotani, N., Hisaoka, T., Noh, J.Y., Ishikawa, N., Ishii, J., Katayama, S., Ito K., 1998. TSH receptor antibody-associated thyroid dysfunction following subacute thyroiditis. Clin. Endocrinol. 48, 445-453.
• Jameson, J.L., Weetman, A.P., 2004. Endokrinoloji ve Metabolizma Bölüm 330. Harrison İç Hastalıları Prensipleri. Sağlıker Y, ed. Nobel Tıp Kitabevi, İstanbul, pp. 2060-2084.
• Lazarus, J.H., Ammari, F., Oretti, R., Parkes, A.B., Richards, C.J., Harris B., 1997. Clinical aspects of recurrent postpartum thyroiditis. Brit. J. Gen. Pract. 47, 305-308.
• Lazarus, J.H., 2009. Lithium and thyroid. Best Pract. Res. Cl. En. 23, 723-733.
• Li, Y., Nishihara, E., Kakudo, K., 2011. Hashimoto’s thyroiditis: Old concepts and new insights. Curr. Opin. Rheumatol. 23,102-107.
• Martino, E., Bartalena, L., Bogazzi, F., Braverman, L.E., 2001. The effects of amiodarone on the thyroid. Endocr. Rev. 22, 240-254.
• Özata M., 2005. Tiroiditler. Tiroid Hastalıklarına Güncel Yaklaşım. İçinde: Özata M., ed. Epsilon Yayıncılık Hizmetleri, İstanbul, 213-239.
• Pearce, E.N., Farwell, A.P., Braverman, L.E., 2003. Thyroiditis. New Engl. J. Med. 348, 2646-2655.
• Schlumberger, M.J., Filetti, S., Hay, I.A., 2008. Nontoxic diffuse and nodular goiter and thyroid neoplasia. In: Williams Textbook of Endocrinol- ogy. Kronenberg HM., Melmed S., Polonsky KS., Larsen PR., ed. Saunders Elsevier, Philadelphia, 411-442.
• Slatosky, J., Shipton, B., Wahba, H., 2000. Thyroiditis: differential diagnosis and management. Am. Fam. Physician. 61,1047-1052.
• Stagnaro-Green A., 2000. Recognizing, understanding and treating postpartum thyroiditis. Endocrin. Metab. Clin.. 29, 417-430.
• Stagnaro-Green A., 2002. Postpartum thyroiditis. J. Clin. Endocr. Metab. 87,4042-4047.
• Stagnaro-Green A., 2004. Postpartum thyroiditis. Best Pract. Res. Cl. En. 18, 303-316.
• Stuckey, B.G., Kent, N., Allen, J.R., 2001. The biochemical and clinical course of postpartum thyroid dysfunction: The treatment decision. Clin. Endocrinol. 54, 377-383.
• Tomer, Y., Menconi, F., 2009. Interferon induced thyroiditis. Best Pract. Res. Cl. En. 23, 703-712.
• Uysal, A.R., 2005. Subakut granülomatöz tiroidit. Koloğlu Endokrinoloji ve Temel Klinik. İçinde: Erdoğan G., ed. Nobel Tıp Kitabevleri, An- kara, 262-265.