Thyroiditis

Question 1

What is subacute thyroiditis?

Answer 1

Acute inflammatory disorder characterised by initial thyrotoxic state followed by hypothyroidism. Most return to euthyroid.
May be painful or painless.

Question 2

Pathophysiology of thyroiditis?

Answer 2

Acute inflammation of thyroid characterised by giant cells and lymphocytes => disruption of thyroid follicles triggers release of stored thyroid hormone.

Question 3

Aetiology of painful thyroiditis?

Answer 3

• Viral (usually preceded by URTI).

- Granulomatous (De Quervain’s)

Question 4

Aetiology of painless thyroiditis?

Answer 4

Pospartum, auto-immune, lymphocytic.

Question 5

Ix results in thyroiditis?

Answer 5

• Elevated T4/T3
• Low TSH
• RAIU markedly reduced

Question 6

Rx subacute thyroiditis?

Answer 6

• Painful: high dose NSAIDs, red if pain/fever severe
• Iodinated contrast agents to inhibit peripheral conversion T4->T3
• B-blocker (revert CV state)