Thyroiditis - Causes, symptoms and treatment. MF.

Thyroiditis is an inflammation of the thyroid gland. If the enlarged thyroid gland is evenly inflamed, then this inflammation is called a strum.

Depending on the onset and course of the disease, different types of of thyroiditis are distinguished:

1. Acute thyroiditis .
2. Subacute or thyroiditis de Kervena.
3. Chronic fibrotic tibreoiditis or Riedel's goiter.
4. Autoimmune chronic or thyroiditis of Hoshimsky.

General information about subacute thyroiditis

Subacute thyroiditis ( thyroiditis de Kervena) - an inflammation of the thyroid gland after a viral infection.

More often( 5-6 times than men) women are sick 30-50 years, 3-6 weeks after the virus infection

General information about fibroid thyroiditis( Riedel's ridge)

Fibrous thyroiditis is a disease characterized by a proliferation of connectivetissues in the thyroid gland and signs of compression in the neck.

Develops more often in women older than 50 years.

General information about autoimmune thyroiditis

Autoimmune chronic thyroiditis or thyroiditis Hashimoto is a chronic inflammatory process in the thyroid gland of autoimmune origin.

Autoimmune origin is when antibodies are formed to the body's own normal cells( particles that "destroy" foreign cells), i.e.cells of the thyroid gland are recognized as alien and a peculiar "struggle" begins, leading to inflammation in the organ.

Disease occurs 4-7 times more often in women than in men. It can develop at any age, but mostly after 60 years.

Symptoms of acute thyroiditis

Acute thyroiditis is clinically expressed:

• with pain in the anterior surface of the neck, which moves to the nape, into the lower and upper jaw, and is strengthened when the head moves and swallows;
• there is an increase in the cervical lymph nodes;
• marked very high fever and chills;
• during palpation - a painful increase in part or whole of the gland.

Symptoms of subacute thyroiditis

The disease usually begins acutely. Local( in the field of the thyroid gland) and general( in the whole body) symptoms are characteristic.

Local Symptoms:

• severe pain in the thyroid( forehead of the neck), which gives to the nape, lower jaw, ears and back of the neck;increased pain occurs when the head turns and tilts, swallowing( very difficult), chewing;the pain lasts for 2-3 weeks;The
• of the gland is completely or in some places enlarged and considerably compacted;
• skin on the front surface of the neck( ie above the gland) hot, painful, hyperemic( reddened, due to increased blood flow to the skin of the neck);
• lymph nodes( provide immune defenses in the place where they are located) in the neck area are not enlarged.

Common Symptoms:

• , patients experience a severe fever, accompanied by chills;
• general weakness, sweating;
• headache;
• at the beginning of the disease in most patients, there are the phenomena of thyrotoxicosis: irritability, sweating, a feeling of heat, weight loss, shine in the eyes, hot, moist skin, tremor of the fingers of outstretched arms.

Symptoms of autoimmune thyroiditis

There is a widespread, sometimes uneven enlargement of the thyroid gland, with palpation of the gland dense and mobile. At large sizes, the patient feels squeezing in the neck.

As the disease progresses, there is a violation of the gland: first develop symptoms of hyperthyroidism due to the receipt of a large number of previously formed hormones, and subsequently there are symptoms of hypothyroidism.

The main complaints of patients:

• enlargement of the thyroid gland;
• difficulty in swallowing;
• may have weakness;
• feeling of neck compression;

With increasing thyroid function, patients are concerned about the feeling of heat, palpitations, sweating, weight loss, irritability.

Symptoms of fibroid thyroiditis

Fibrous thyroiditis develops very slowly, and most importantly its insidiousness is that for a long time the general condition of the patient does not suffer and it is difficult to identify the disease. The earliest symptom of the disease is difficulty in swallowing and feeling "lump in the throat".

When fibrotic thyroiditis acquires a detailed state, the patients will have a complete clinical picture in the form of the following symptoms:

• in patients is disturbed by breathing, swallowing, difficulty speaking, very often perforated during meals;
• the voice becomes hoarse;
• the thyroid gland is quite strong and unevenly enlarged, very dense, painless, does not move when swallowed( sedentary), has a knobby surface. All parts of the gland are affected, but, sometimes, the inflammation can also be located in one specific area. With the long-term course of the disease, the organ can acquire a "woody" density;
• is characterized by the development of compression syndrome, which manifests itself: headache, tinnitus, visual impairment, difficulty in swallowing, impaired breathing, pronounced pulsation of vessels in the neck;
• may develop symptoms of hypothyroidism.

Causes of acute thyroiditis

Acute thyroiditis can be purulent or nasal, common( a whole or whole thyroid gland is affected) or local( lesion of only part of the lobe of the gland).

Acute purulent thyroiditis develops against a background of acute or chronic infection( tonsillitis - inflammation of the tonsils, pneumonia - pneumonia, etc.).

Acute pristine thyroiditis can develop after trauma, hemorrhage in the gland, radiation therapy.

Causes of subacute thyroiditis

The cause of subacute thyroiditis is a viral infection, but a specific virus for this disease has not been identified. May be caused by influenza viruses, measles( acute infectious disease), mumps( mumps).

This reason is proved by the fact that the disease is established during a period of outbreak of a viral infection and in all patients antibodies to adenoviruses and influenza viruses are detected( after the disease the person in the blood has an increase in special cells - antibodies that "destroy" specific viral cells).

The predisposing factors to the onset of this disease are hereditary predisposition and the presence of a chronic infection in the nasopharyngeal region of

. The causes of autoimmune chronic thyroiditis.

There are three groups of causative factors for the onset of the disease: external, internal, and diseases in which autoimmune thyroiditis is a "second" disease.

Internal causative factors are hereditary and predisposing factors.

The role of heredity in the development of the disease is confirmed by the presence of family forms of the disease, the emergence of thyroiditis in twins in the same family.

A predisposing internal factor is a violation of the immune and endocrine consistency in adolescence, during pregnancy, during childbirth, and also during aging.

External causative factors include:

1. Pollution of the environment by industrial waste, which can have a negative effect on human immunity and lead to the development of autoimmune thyroiditis.
2. The use of pesticides in agriculture, which has a negative effect on immunity.
3. Prolonged intake of excess iodine increases the frequency of autoimmune thyroiditis, since with prolonged use in high doses it stimulates the production of antibodies to thyroid cells. The use of iodine in a daily dose of 100-200 m / kg. There is no negative influence.
4. Exposure to small doses of radiation can lead to increased production of antibodies to normal thyroid cells.
5. May also contribute to the development of autoimmune thyroiditis - viral and bacterial infections.

Autoimmune chronic thyroiditis may accompany other thyroid diseases and be a "second disease".This is possible with Based's disease, endemic goiter, adenoma( benign tumor) and cancer of the gland.

Causes of fibroid thyroiditis

The causes of the disease are completely unknown. There is an opinion on the role of infectious diseases in the development of goitre Riedel, and some researchers believe that this disease is the final stage of autoimmune thyroiditis.

To the risk factors are:

1. People who have been infected with Basid's disease.
2. Patients with any form of endemic goiter.
3. Postoperative operation on the thyroid gland.
4. Patients with diabetes mellitus.
5. People suffering from allergic and autoimmune diseases.
6. Women over 40 years old.
7. People with hereditary predisposition.

Diagnosis of thyroiditis

1. General blood test.
2. Immunological examination of blood - detection of antibody content( for autoimmune thyroiditis ).
3. The ultrasound of the thyroid gland helps to identify tumors or nodules formed in the gland.
4. Blood test for thyroid hormones.
5. Radioisotope thyroid scintigraphy( with fibrotic thyroiditis Riedel) with radioactive iodine - it helps to detect an increase in the size of the thyroid gland, fuzzy contours, change in shape.

Treatment of thyroiditis

Treatment of acute thyroiditis.

With acute thyroiditis, is prescribed antibiotics and drugs to treat associated symptoms, as well as vitamins C and B. When the abscess develops( purulent inflammation of the tissue), surgical treatment is indicated.

Treatment of subacute thyroiditis.

Treat this disease with hormonal medications, and when symptoms of hypothyroidism or hyperthyroidism appear, it treats these diseases.

Treatment of chronic autoimmune thyroiditis.

Treatment is mainly medicated( thyroid hormones), but with a strong increase in the thyroid gland in size, surgery is indicated.

Treatment of fibrotic thyroiditis.

If in chronic thyroiditis symptoms of hypothyroidism are observed, the treatment is produced with thyroid hormones, if signs of compression in the neck are observed, then surgical intervention is necessary.