Subacute lymphocytic thyroiditis explained

Synonym:Silent thyroiditis or Painless thyroiditis
Specialty:Endocrinology

Subacute lymphocytic thyroiditis is a form of thyroiditis. Subacute lymphocytic thyroiditis may occur at any age and is more common in females. A variant of subacute lymphocytic thyroiditis occurs postpartum: postpartum thyroiditis. Both of these entities can be considered subtypes of Hashimoto's thyroiditis and have an autoimmune basis. Anti-thyroid antibodies are common in all three and the underlying histology is similar. [1] This disorder should not be confused with de Quervain's thyroiditis which is another form of subacute thyroiditis.

Symptoms and signs

Subacute lymphocytic thyroiditis features a small goiter without tenderness. This condition tends to have a phase of hyperthyroidism followed by a return to a euthyroid state, and then a phase of hypothyroidism, followed again by a return to the euthyroid state. The time span of each phase can vary; however, each phase usually lasts 2–3 months.[1]

Diagnosis

Subacute lymphocytic thyroiditis can only be diagnosed correctly by taking a radioactive iodine uptake test (RAIU) test.[1] [2] During both the hyperthyroid and hypothyroid phases, radioiodine uptake is decreased.[3] This situation contrasts greatly with the elevated iodine uptake found in patients with Graves' disease.[1]

Treatment

Treatment is based on symptoms. Beta-blockers relieve rapid heart rate and excessive sweating during the hyperthyroid phase.[3]

Notes and References

  1. http://www.aafp.org/afp/20000215/1047.html Thyroiditis: Differential Diagnosis and Management, American Family Physician, February 15, 2000
  2. http://www.webmd.com/a-to-z-guides/radioactive-iodine-uptake-test Description of Radioactive Iodine Uptake Test, WebMD.com, August 14, 2008
  3. https://www.nlm.nih.gov/MEDLINEPLUS/ency/article/000388.htm NIH Medline Plus