Subacute thyroiditis. The release of colloid into the interstitial tissue has elicited a prominent granulomatous reaction, with numerous foreign body giant cells.
thyroid gland with lymphocytic thyroiditis. A follicle (black arrow) is surrounded by a densely cellular infiltrate of lymphocytes and plasma cells (white arrow).
Ahmed Adel Fouad Abdelhakeem
is a general term that refers to
“inflammation of the thyroid gland”.
Thyroiditis includes a group of individual
disorders that all cause thyroidal
inflammation and, as a result, causes many
different clinical presentations.
most common cause of thyroiditis.
form of thyroid disease may also be
referred to as chronic lymphocytic
is characterized by:
Gradual thyroid failure because of autoimmune
destruction of the thyroid gland.
name Hashimoto thyroiditis is derived
from the 1912 report by Hashimoto describing
patients with goiter and intense lymphocytic
infiltration of the thyroid (struma
is primarily a disease of older women.
occur in children “ nonendemic goiter”
concordance rate in monozygotic twins
is 30% to 60%.
chromosomal abnormalities have
been associated with thyroid autoimmunity.
are reports that polymorphisms in the
HLA locus, specifically the HLA-DR3 and HLADR5 alleles, are linked to Hashimoto
thyroiditis, but the association is weak.
wide linkage analyses in families
with Hashimoto thyroiditis have provided
evidence for several susceptibility loci, such
as on chromosomes 6p and 12q, that may
harbor genes predisposing to this disorder.
thyroiditis is an autoimmune
disease in which the immune system reacts
against a variety of thyroid antigens.
is progressive depletion of thyroid
epithelial cells (thyrocytes), which are
gradually replaced by mononuclear cell
infiltration and fibrosis.
thyroid is often diffusely enlarged.
capsule is intact.
gland is well demarcated from adjacent
cut surface is pale, yellow-tan, firm, and
many of the symptoms associated with thyroid
Difficulty with learning
Dry, brittle hair and nails
Dry, itchy skin
Heavy menstrual flow
Increased frequency of miscarriages
Increased sensitivity to many medications.
a self-limited thyroid condition.
with a triphasic clinical course of
hyperthyroidism, hypothyroidism, and return
to normal thyroid function.
for 15-20% of patients presenting
10% of patients presenting with
subacute painful, or “de
(also known as subacute
Subacute granulomatous thyroiditis
Possible viral cause.
Enlarged Gland, Tender
thyrotoxicosis followed by hypothyroidism.
Infiltration of chronic inflammatory cells.
Foreign Body giant cells “ Giant Cell Thyroiditis “
Anti-thyroid antibodies, autoimmune disease
Thyrotoxicosis followed by hypothyroidism.
Non-Specific lymphoid infiltration of thyroid parenchyma.
No germinal center formation.
is the type of thyroiditis that may occur
in women after they give birth.
return to Normal state.
the first one to four months after
This phase can be characterized by :
slight enlargement of the thyroid .
tests to measure :
increased levels of thyroid hormone in the
the abnormal antibodies, anti-microsomal
and antithyroglobulin antibodies.
fine needle aspiration biopsy of the thyroid
gland during this phase would reveal
inflammatory cells attacking the thyroid
this hyperthyroid phase, treatment is
usually not recommended because this phase
usually lasts for a short period of time, about
2 to 4 months.
if the symptoms are extreme, beta
blockers may be used to slow the heart rate
and decrease nervousness.
3 to 8 months postpartum.
This phase can be characterized by:
slight enlargement of the thyroid gland.
lack of energy .
hormone medication for about six
After this time, the medication is stopped to
determine whether or not the thyroid has
recovered its normal function.
If so, the medication may be stopped
permanently, otherwise the medication must
be resumed because of permanent injury to
the thyroid gland.
suppurative thyroiditis is quite rare in
It is caused by a bacterial infection in the
thyroid which causes pus to collect and form
an abscess within the thyroid gland.
The bacterial infection may be carried in the
bloodstream from anywhere in the body or it
may come from the throat itself.
painless enlargement of the thyroid.
The symptoms usually resolve once the
In the few instances where it still
occurs, antibiotics and surgery to drain the
pus can result in complete cure.
Drugs include: amiodarone, lithium,
Either thyrotoxicosis or hypothyroidism.
Often continues as long as the drug is taken.
Follows treatment with radioactive iodine for
external beam radiation therapy for certain
1. Occasionally thyrotoxicosis
2. more frequently hypothyroidism.
depends on the type of thyroiditis
and the clinical presentation.
blockers to decrease palpitations and
reduce shakes and tremors may be helpful.