Riedel's thyroiditis differential diagnosis: Difference between revisions

Latest revision as of 00:01, 30 July 2020

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Furqan M M. M.B.B.S [2]

Overview

Riedel's thyroiditis must be differentiated from other causes of thyroiditis, such as De Quervain's thyroiditis, Hashimoto's thyroiditis, Riedel's thyroiditis, and suppurative thyroiditis.

Differentiating Riedel's Thyroiditis from other Diseases

Riedel's thyroiditis must be differentiated from other causes of thyroiditis, such as De Quervain's thyroiditis, Hashimoto's thyroiditis, Riedel's thyroiditis, and suppurative thyroiditis.^[1]

Conditions	Causes	Age at onset	Pathological findings	Diagnostic findings
Riedel's thyroiditis	Unknown	30-60	Dense fibrosis	Normal TSH (euthyroidism) TPO antibodies usually present I-123 uptake decreased or normal
Hashimoto's thyroiditis	Autoimmune	All ages, peak at 30-50	Lymphocytic infiltration Germinal centers Fibrosis (in some variants)	Increased TSH (hypothyroidism) TPO antibodies present in high titer I-123 uptake usually decreased
Painful subacute (De Quervain's) thyroiditis	Unknown	20-60	Giant cells Granulomas	Increased TSH (hypothyroidism) and/or Decreased TSH (Thyrotoxicosis) TPO antibodies absent or very low titer I-123 uptake decreased
Silent thyroiditis	Autoimmune	All ages, peak at 30-40	Lymphocytic infiltration Lymphoid follicles	Increased TSH (hypothyroidism) and/or Decreased TSH (transient hypothyroidism) TPO antibodies present in high titer I-123 uptake usually decreased
Postpartum thyroiditis	Autoimmune	Childbearing age	Lymphocytic infiltration	Increased TSH (hypothyroidism) and/or Decreased TSH (transient hypothyroidism) TPO antibodies present in high titer I-123 uptake usually decreased
Suppurative thyroiditis	Infection	Children, 20-40	Abscess formation	Normal TSH (euthyroidism) TPO antibodies absent I-123 uptake normal

Riedel's thyroiditis must be differentiated from other causes of hypothyroidism on the basis of history and symptoms and laboratory findings:^[2]^[3]^[1]^[4]^[5]^[6]

Disease		History and symptoms		Laboratory findings							Additional findings
Disease		Fever	Pain	TSH	Free T4	T3	T3RU^†	Thyroglobin	TRH	TPOAb^{^}	Additional findings
Primary hypothyroidism	Riedel's thyroiditis	-	-	Normal/↑	Normal/↓	Normal/↓	Normal/↓	Normal	Normal	Usually present	Riedel's thyroiditis usually presents with hard and fixed thyroid mass.
	Autoimmune (Hashimoto's thyroiditis)	-	-	↑*	↓	Normal/↓	Normal/↓	Normal/↑	Normal	Present (high titer)	May be accompanied by other autoimmune diseases
	Infectious thyroiditis	+	+	Normal	Normal	Normal	Normal	Normal	Normal	Absent	Infectious thyroiditis associated with neck pain
Transient hypothyroidism	Subacute (de Quervain's) thyroiditis	+/-	+/-	↑/↓	↓/↑	Normal	↓	↑	Normal	Low/absent	May present primarily with hyperthyroidism
	Postpartum thyroiditis	+/-	+/-	↑/↓	↓/↑	Normal	↓	↑	Normal/↑	Present (high titer)	May present primarily with hyperthyroidism
	Silent thyroiditis	-	-	↑/↓	↓/↑	Normal	↓	↑	Normal	Present (high titer)	May present primarily with hyperthyroidism
Others	Drug-induced	-	-	↑/↓	↓/↑	Normal	↓	Normal/↑	Normal	Absent**	History of hyperthyroidism History of trauma History of drug use, surgery, or radiation
	Radiation-induced
	Trauma induced
	Radioiodine induced
	Thyroidectomy
	Subclinical hypothyroidism	-	-	↑	Normal	Normal	Normal	Normal	Normal	Normal/↑	Asymptomatic

†: T3RU; Triiodothyronine Resin uptake

^: TPOAb; Thyroid peroxidase antibodies

*: TSH may be decreased transiently in the thyrotoxicosis

**: TPOAb may be present in drug-induced hypo/hyperthyroidism such as Interferon-alpha, interleukin-2, and lithium.

References

↑ ^1.0 ^1.1 "Thyroiditis — NEJM".
↑ Bindra A, Braunstein GD (2006). "Thyroiditis". Am Fam Physician. 73 (10): 1769–76. PMID 16734054.
↑ McDermott MT (2009). "In the clinic. Hypothyroidism". Ann. Intern. Med. 151 (11): ITC61. doi:10.7326/0003-4819-151-11-200912010-01006. PMID 19949140.
↑ Aoki Y, Belin RM, Clickner R, Jeffries R, Phillips L, Mahaffey KR (2007). "Serum TSH and total T4 in the United States population and their association with participant characteristics: National Health and Nutrition Examination Survey (NHANES 1999-2002)". Thyroid. 17 (12): 1211–23. doi:10.1089/thy.2006.0235. PMID 18177256.
↑ Lania A, Persani L, Beck-Peccoz P (2008). "Central hypothyroidism". Pituitary. 11 (2): 181–6. doi:10.1007/s11102-008-0122-6. PMID 18415684.
↑ De Groot LJ, Chrousos G, Dungan K, Feingold KR, Grossman A, Hershman JM, Koch C, Korbonits M, McLachlan R, New M, Purnell J, Rebar R, Singer F, Vinik A, Stockigt J. "Clinical Strategies in the Testing of Thyroid Function". PMID 25905413.

Template:WH Template:WS

[urlThyroiditis_—_NEJM-1] 1.0 ^1.1 "Thyroiditis — NEJM".

[pmid16734054-2] Bindra A, Braunstein GD (2006). "Thyroiditis". Am Fam Physician. 73 (10): 1769–76. PMID 16734054.

[pmid19949140-3] McDermott MT (2009). "In the clinic. Hypothyroidism". Ann. Intern. Med. 151 (11): ITC61. doi:10.7326/0003-4819-151-11-200912010-01006. PMID 19949140.

[pmid18177256-4] Aoki Y, Belin RM, Clickner R, Jeffries R, Phillips L, Mahaffey KR (2007). "Serum TSH and total T4 in the United States population and their association with participant characteristics: National Health and Nutrition Examination Survey (NHANES 1999-2002)". Thyroid. 17 (12): 1211–23. doi:10.1089/thy.2006.0235. PMID 18177256.

[pmid18415684-5] Lania A, Persani L, Beck-Peccoz P (2008). "Central hypothyroidism". Pituitary. 11 (2): 181–6. doi:10.1007/s11102-008-0122-6. PMID 18415684.

[pmid25905413-6] De Groot LJ, Chrousos G, Dungan K, Feingold KR, Grossman A, Hershman JM, Koch C, Korbonits M, McLachlan R, New M, Purnell J, Rebar R, Singer F, Vinik A, Stockigt J. "Clinical Strategies in the Testing of Thyroid Function". PMID 25905413.

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@@ Line 1: / Line 1: @@
 __NOTOC__
-{{Riedel's thyroiditis}}
+[[Image:Home_logo1.png|right|250px|link=http://www.wikidoc.org/index.php/Riedel%27s_thyroiditis]]
-{{CMG}}; {{AE}}
+{{CMG}} {{AE}} {{MMF}}
 ==Overview==
-*[Disease name] must be differentiated from other diseases that cause [clinical feature 1], [clinical feature 2], and [clinical feature 3], such as [differential dx1], [differential dx2], and [differential dx3].
+Riedel's thyroiditis must be differentiated from other causes of [[thyroiditis]], such as [[De Quervain's thyroiditis]], [[Hashimoto's thyroiditis]], [[Riedel's thyroiditis]], and suppurative thyroiditis.
-*[Disease name] must be differentiated from [[differential dx1], [differential dx2], and [differential dx3].
+==Differentiating Riedel's Thyroiditis from other Diseases==
+*Riedel's thyroiditis must be differentiated from other causes of [[thyroiditis]], such as [[De Quervain's thyroiditis]], [[Hashimoto's thyroiditis]], [[Riedel's thyroiditis]], and suppurative thyroiditis.<ref name="urlThyroiditis — NEJM">{{cite web |url=http://www.nejm.org/doi/full/10.1056/NEJMra021194 |title=Thyroiditis — NEJM |format= |work= |accessdate=}}</ref>
+{| align="center"
+|-
+|}
+{| style="border: 0px; font-size: 90%; margin: 3px;" align="center"
+! style="background:#4479BA; color: #FFFFFF;" | Conditions
+! style="background:#4479BA; color: #FFFFFF;" |Causes
+! style="background:#4479BA; color: #FFFFFF;" |Age at onset
+! style="background:#4479BA; color: #FFFFFF;" |Pathological findings
+! style="background:#4479BA; color: #FFFFFF;" |Diagnostic findings
+|-
+| align="center" style="background:#DCDCDC;" |[[Riedel's thyroiditis]]
+| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
+*Unknown
+| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
+*30-60
+| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
+*Dense fibrosis
+| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
+*[[Thyroid function tests|Normal TSH]] (euthyroidism)
+*[[Thyroid peroxidase|TPO antibodies]] usually present
+*[[I-123 thyroid imaging|I-123]] uptake decreased or normal
+|-
+| align="center" style="background:#DCDCDC;" |[[Hashimoto's thyroiditis]]
+| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
+*[[Autoimmunity|Autoimmune]]
+| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
+*All ages, peak at 30-50
+| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
+*Lymphocytic infiltration
+*[[Germinal center|Germinal centers]]
+*[[Fibrosis]] (in some variants)
+| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
+*[[Thyroid function tests|Increased TSH]] ([[hypothyroidism]])
+*[[Thyroid peroxidase|TPO antibodies]] present in high titer
+*[[I-123 thyroid imaging|I-123]] uptake usually decreased
+|-
+| align="center" style="background:#DCDCDC;" |[[De Quervain's thyroiditis|Painful subacute (De Quervain's) thyroiditis]]
+| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
+*Unknown
+| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
+*20-60
+| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
+*Giant cells
+*[[Granuloma|Granulomas]]
+| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
+*[[Thyroid function tests|Increased TSH]] ([[hypothyroidism]]) and/or
+* [[Thyroid function tests|Decreased TSH]] ([[Hyperthyroidism|Thyrotoxicosis]])
+*[[Thyroid peroxidase|TPO antibodies]] absent or very low titer
+*[[I-123 thyroid imaging|I-123]] uptake decreased
+|-
+| align="center" style="background:#DCDCDC;" |[[Silent thyroiditis]]
+| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
+*[[Autoimmunity|Autoimmune]]
+| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
+*All ages, peak at 30-40
+| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
+*Lymphocytic infiltration
+*Lymphoid follicles
+| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
+*[[Thyroid function tests|Increased TSH]] ([[hypothyroidism]]) and/or
+* [[Thyroid function tests|Decreased TSH]] (transient [[hypothyroidism]])
+*[[Thyroid peroxidase|TPO antibodies]] present in high titer
+*[[I-123 thyroid imaging|I-123]] uptake usually decreased
+|-
+| align="center" style="background:#DCDCDC;" |[[Postpartum thyroiditis]]
+| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
+*[[Autoimmunity|Autoimmune]]
+| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
+*Childbearing age
+| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
+*Lymphocytic infiltration
+| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
+*[[Thyroid function tests|Increased TSH]] (hypothyroidism) and/or
+* [[Thyroid function tests|Decreased TSH]] (transient hypothyroidism)
+*[[Thyroid peroxidase|TPO antibodies]] present in high titer
+*[[I-123 thyroid imaging|I-123]] uptake usually decreased
+|-
+| align="center" style="background:#DCDCDC;" |[[Suppurative thyroiditis]]
+| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
+*Infection
+| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
+*Children, 20-40
+| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
+*[[Abscess]] formation
+| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
+*[[Thyroid function tests|Normal TSH]] (euthyroidism)
+*[[Thyroid peroxidase|TPO antibodies]] absent
+*[[I-123 thyroid imaging|I-123]] uptake normal
+|}
-==Differentiating X from other Diseases==
+*Riedel's thyroiditis must be differentiated from other causes of [[hypothyroidism]] on the basis of history and symptoms and laboratory findings:<ref name="pmid16734054">{{cite journal |vauthors=Bindra A, Braunstein GD |title=Thyroiditis |journal=Am Fam Physician |volume=73 |issue=10 |pages=1769–76 |year=2006 |pmid=16734054 |doi= |url=}}</ref><ref name="pmid19949140">{{cite journal |vauthors=McDermott MT |title=In the clinic. Hypothyroidism |journal=Ann. Intern. Med. |volume=151 |issue=11 |pages=ITC61 |year=2009 |pmid=19949140 |doi=10.7326/0003-4819-151-11-200912010-01006 |url=}}</ref><ref name="urlThyroiditis — NEJM">{{cite web |url=http://www.nejm.org/doi/full/10.1056/NEJMra021194 |title=Thyroiditis — NEJM |format= |work= |accessdate=}}</ref><ref name="pmid18177256">{{cite journal |vauthors=Aoki Y, Belin RM, Clickner R, Jeffries R, Phillips L, Mahaffey KR |title=Serum TSH and total T4 in the United States population and their association with participant characteristics: National Health and Nutrition Examination Survey (NHANES 1999-2002) |journal=Thyroid |volume=17 |issue=12 |pages=1211–23 |year=2007 |pmid=18177256 |doi=10.1089/thy.2006.0235 |url=}}</ref><ref name="pmid18415684">{{cite journal |vauthors=Lania A, Persani L, Beck-Peccoz P |title=Central hypothyroidism |journal=Pituitary |volume=11 |issue=2 |pages=181–6 |year=2008 |pmid=18415684 |doi=10.1007/s11102-008-0122-6 |url=}}</ref><ref name="pmid25905413">{{cite journal |vauthors=De Groot LJ, Chrousos G, Dungan K, Feingold KR, Grossman A, Hershman JM, Koch C, Korbonits M, McLachlan R, New M, Purnell J, Rebar R, Singer F, Vinik A, Stockigt J |title=Clinical Strategies in the Testing of Thyroid Function |journal= |volume= |issue= |pages= |year= |pmid=25905413 |doi= |url=}}</ref>
-*[Disease name] must be differentiated from other diseases that cause [clinical feature 1], [clinical feature 2], and [clinical feature 3], such as [differential dx1], [differential dx2], and [differential dx3].
-*[Disease name] must be differentiated from [[differential dx1], [differential dx2], and [differential dx3].
-*As [disease name] manifests in a variety of clinical forms, differentiation must be established in accordance with the particular subtype. [Subtype name 1] must be differentiated from other diseases that cause [clinical feature 1], such as [differential dx1] and [differential dx2]. In contrast, [subtype name 2] must be differentiated from other diseases that cause [clinical feature 2], such as [differential dx3] and [differential dx4].
+{| class="wikitable" align="center" style="border: 0px; margin: 3px;"
+! colspan="2" rowspan="2" align="center" style="background: #4479BA; color: #FFFFFF; " |Disease
-===Preferred Table===
+! colspan="2" align="center" style="background: #4479BA; color: #FFFFFF; " |History and symptoms
-{|
+! colspan="7" align="center" style="background: #4479BA; color: #FFFFFF; " |Laboratory findings
-|-style="background: #4479BA; color: #FFFFFF; text-align: center;"
+! rowspan="2" align="center" style="background: #4479BA; color: #FFFFFF; " |Additional findings
-! rowspan="2" |Diseases
+|-
-! colspan="4" |Laboratory Findings
+! align="center" style="background: #4479BA; color: #FFFFFF; " |<small> Fever
-! colspan="4" |Physical Examination
+! align="center" style="background: #4479BA; color: #FFFFFF; " |<small> Pain
-! colspan="4" |History and Symptoms
+! align="center" style="background: #4479BA; color: #FFFFFF; " |<small> TSH
-! rowspan="2" |Other Findings
+! align="center" style="background: #4479BA; color: #FFFFFF; " |<small> Free T4
-|-style="background: #4479BA; color: #FFFFFF; text-align: center;"
+! align="center" style="background: #4479BA; color: #FFFFFF; " |<small> T3
-!Lab Test 1
+! align="center" style="background: #4479BA; color: #FFFFFF; " |<small> T3RU<small><sup>†</sup>
-!Lab Test 2
+! align="center" style="background: #4479BA; color: #FFFFFF; " |<small> Thyroglobin
-!Lab Test 3
+! align="center" style="background: #4479BA; color: #FFFFFF; " |<small> TRH
-!Lab Test 4
+! align="center" style="background: #4479BA; color: #FFFFFF; " |<small> TPOAb<sup>^</sup>
-!Physical Finding 1
+|-
-!Physical Finding 2
+| rowspan="3" style="background:#DCDCDC;" |[[Primary hypothyroidism]]
-!Physical Finding 3
+| align="center" style="background:#DCDCDC;" |[[Riedel's thyroiditis]]
-!Physical Finding 4
+| align="center" style="padding: 5px 5px; background: #F5F5F5;" | -
-!Finding 1
+| align="center" style="padding: 5px 5px; background: #F5F5F5;" | -
-!Finding 2
+| align="center" style="padding: 5px 5px; background: #F5F5F5;" |Normal/↑
-!Finding 3
+| align="center" style="padding: 5px 5px; background: #F5F5F5;" |Normal/↓
-!Finding 4
+| align="center" style="padding: 5px 5px; background: #F5F5F5;" |Normal/↓
+| align="center" style="padding: 5px 5px; background: #F5F5F5;" |Normal/↓
+| align="center" style="padding: 5px 5px; background: #F5F5F5;" |Normal
+| align="center" style="padding: 5px 5px; background: #F5F5F5;" |Normal
+| align="center" style="padding: 5px 5px; background: #F5F5F5;" |Usually present
+| align="left" style="padding: 5px 5px; background: #F5F5F5;" |
+*[[Riedel's thyroiditis]] usually presents with hard and fixed thyroid mass.
+|-
+| align="center" style="background:#DCDCDC;" |[[Hashimoto's thyroiditis|Autoimmune]] ([[Hashimoto's thyroiditis]])
+| align="center" style="padding: 5px 5px; background: #F5F5F5;" | -
+| align="center" style="padding: 5px 5px; background: #F5F5F5;" | -
+| align="center" style="padding: 5px 5px; background: #F5F5F5;" |'''↑'''<small>*
+| align="center" style="padding: 5px 5px; background: #F5F5F5;" |'''''↓'''''
+| align="center" style="padding: 5px 5px; background: #F5F5F5;" |Normal/'''''↓'''''
+| align="center" style="padding: 5px 5px; background: #F5F5F5;" |Normal/↓
+| align="center" style="padding: 5px 5px; background: #F5F5F5;" |Normal/'''↑'''
+| align="center" style="padding: 5px 5px; background: #F5F5F5;" |Normal
+| align="center" style="padding: 5px 5px; background: #F5F5F5;" |Present (high titer)
+| align="left" style="padding: 5px 5px; background: #F5F5F5;" |
+* May be accompanied by other [[autoimmune diseases]]
+|-
+| align="center" style="background:#DCDCDC;" |[[Thyroiditis|Infectious thyroiditis]]
+| align="center" style="padding: 5px 5px; background: #F5F5F5;" | +
+| align="center" style="padding: 5px 5px; background: #F5F5F5;" | +
+| align="center" style="padding: 5px 5px; background: #F5F5F5;" |Normal
+| align="center" style="padding: 5px 5px; background: #F5F5F5;" |Normal
+| align="center" style="padding: 5px 5px; background: #F5F5F5;" |Normal
+| align="center" style="padding: 5px 5px; background: #F5F5F5;" |Normal
+| align="center" style="padding: 5px 5px; background: #F5F5F5;" |Normal
+| align="center" style="padding: 5px 5px; background: #F5F5F5;" |Normal
+| align="center" style="padding: 5px 5px; background: #F5F5F5;" |Absent
+| align="left" style="padding: 5px 5px; background: #F5F5F5;" |
+*[[Thyroiditis|Infectious thyroiditis]] associated with [[neck pain]]
 |-
-|style="background: #DCDCDC; padding: 5px; text-align: center;" |Differential Diagnosis 1
+| rowspan="3" style="background:#DCDCDC;" |[[Hypothyroidism|Transient hypothyroidism]]
-|style="background: #F5F5F5; padding: 5px;" |
+| align="center" style="background:#DCDCDC;" |[[De Quervain's thyroiditis|Subacute (de Quervain's) thyroiditis]]
-|style="background: #F5F5F5; padding: 5px;" |
+| align="center" style="padding: 5px 5px; background: #F5F5F5;" | +/-
-|style="background: #F5F5F5; padding: 5px;" |<nowiki>+</nowiki>
+| align="center" style="padding: 5px 5px; background: #F5F5F5;" | +/-
-|style="background: #F5F5F5; padding: 5px;" |
+| align="center" style="padding: 5px 5px; background: #F5F5F5;" |'''↑/'''↓
-|style="background: #F5F5F5; padding: 5px;" |
+| align="center" style="padding: 5px 5px; background: #F5F5F5;" |↓/'''↑'''
-|style="background: #F5F5F5; padding: 5px;" |
+| align="center" style="padding: 5px 5px; background: #F5F5F5;" |Normal
-|style="background: #F5F5F5; padding: 5px;" |
+| align="center" style="padding: 5px 5px; background: #F5F5F5;" |↓
-|style="background: #F5F5F5; padding: 5px;" |
+| align="center" style="padding: 5px 5px; background: #F5F5F5;" |↑
-| style="background: #F5F5F5; padding: 5px;" |
+| align="center" style="padding: 5px 5px; background: #F5F5F5;" |Normal
-|style="background: #F5F5F5; padding: 5px;" |
+| align="center" style="padding: 5px 5px; background: #F5F5F5;" |Low/absent
-|style="background: #F5F5F5; padding: 5px;" |
+| align="left" style="padding: 5px 5px; background: #F5F5F5;" |
-|style="background: #F5F5F5; padding: 5px;" |
+*May present primarily with [[hyperthyroidism]]
-|style="background: #F5F5F5; padding: 5px;" |
 |-
-|style="background: #DCDCDC; padding: 5px; text-align: center;" |Differential Diagnosis 2
+| align="center" style="background:#DCDCDC;" |[[Postpartum thyroiditis]]
-|style="background: #F5F5F5; padding: 5px;" |'''↑'''
+| align="center" style="padding: 5px 5px; background: #F5F5F5;" | +/-
-|style="background: #F5F5F5; padding: 5px;" |
+| align="center" style="padding: 5px 5px; background: #F5F5F5;" | +/-
-|style="background: #F5F5F5; padding: 5px;" |
+| align="center" style="padding: 5px 5px; background: #F5F5F5;" |'''↑/'''↓
-|style="background: #F5F5F5; padding: 5px;" |-
+| align="center" style="padding: 5px 5px; background: #F5F5F5;" |↓/'''↑'''
-|style="background: #F5F5F5; padding: 5px;" |
+| align="center" style="padding: 5px 5px; background: #F5F5F5;" |Normal
-|style="background: #F5F5F5; padding: 5px;" |
+| align="center" style="padding: 5px 5px; background: #F5F5F5;" |↓
-|style="background: #F5F5F5; padding: 5px;" |
+| align="center" style="padding: 5px 5px; background: #F5F5F5;" |↑
-|style="background: #F5F5F5; padding: 5px;" |
+| align="center" style="padding: 5px 5px; background: #F5F5F5;" |Normal/↑
-|style="background: #F5F5F5; padding: 5px;" |
+| align="center" style="padding: 5px 5px; background: #F5F5F5;" |Present (high titer)
-| style="background: #F5F5F5; padding: 5px;" |
+| align="left" style="padding: 5px 5px; background: #F5F5F5;" |
-|style="background: #F5F5F5; padding: 5px;" |
+*May present primarily with [[hyperthyroidism]]
-|style="background: #F5F5F5; padding: 5px;" |
-|style="background: #F5F5F5; padding: 5px;" |
 |-
-|style="background: #DCDCDC; padding: 5px; text-align: center;" |Differential Diagnosis 3
+| align="center" style="background:#DCDCDC;" |[[Silent thyroiditis]]
-|style="background: #F5F5F5; padding: 5px;" |
+| align="center" style="padding: 5px 5px; background: #F5F5F5;" | -
-|style="background: #F5F5F5; padding: 5px;" |↓
+| align="center" style="padding: 5px 5px; background: #F5F5F5;" | -
-|style="background: #F5F5F5; padding: 5px;" |
+| align="center" style="padding: 5px 5px; background: #F5F5F5;" |'''↑/'''↓
-|style="background: #F5F5F5; padding: 5px;" |
+| align="center" style="padding: 5px 5px; background: #F5F5F5;" |↓/'''↑'''
-|style="background: #F5F5F5; padding: 5px;" |
+| align="center" style="padding: 5px 5px; background: #F5F5F5;" |Normal
-|style="background: #F5F5F5; padding: 5px;" |
+| align="center" style="padding: 5px 5px; background: #F5F5F5;" |↓
-|style="background: #F5F5F5; padding: 5px;" |
+| align="center" style="padding: 5px 5px; background: #F5F5F5;" |↑
-|style="background: #F5F5F5; padding: 5px;" |
+| align="center" style="padding: 5px 5px; background: #F5F5F5;" |Normal
-|style="background: #F5F5F5; padding: 5px;" |
+| align="center" style="padding: 5px 5px; background: #F5F5F5;" |Present (high titer)
-|style="background: #F5F5F5; padding: 5px;" |
+| align="left" style="padding: 5px 5px; background: #F5F5F5;" |
-|style="background: #F5F5F5; padding: 5px;" |
+*May present primarily with [[hyperthyroidism]]
-|style="background: #F5F5F5; padding: 5px;" |
-|style="background: #F5F5F5; padding: 5px;" |
 |-
-|style="background: #DCDCDC; padding: 5px; text-align: center;" |Differential Diagnosis 4
+| rowspan="8" style="background:#DCDCDC;" |Others
-|style="background: #F5F5F5; padding: 5px;" |
+| align="center" style="background:#DCDCDC;" |Drug-induced
-|style="background: #F5F5F5; padding: 5px;" |
+| rowspan="5" align="center" style="padding: 5px 5px; background: #F5F5F5;" | -
-|style="background: #F5F5F5; padding: 5px;" |
+| rowspan="5" align="center" style="padding: 5px 5px; background: #F5F5F5;" | -
-|style="background: #F5F5F5; padding: 5px;" |
+| rowspan="5" align="center" style="padding: 5px 5px; background: #F5F5F5;" |'''↑'''/↓
-|style="background: #F5F5F5; padding: 5px;" |
+| rowspan="5" align="center" style="padding: 5px 5px; background: #F5F5F5;" |'''''↓'''''/↑
-|style="background: #F5F5F5; padding: 5px;" |
+| rowspan="5" align="center" style="padding: 5px 5px; background: #F5F5F5;" |Normal
-|style="background: #F5F5F5; padding: 5px;" |
+| rowspan="5" align="center" style="padding: 5px 5px; background: #F5F5F5;" |↓
-|style="background: #F5F5F5; padding: 5px;" |
+| rowspan="5" align="center" style="padding: 5px 5px; background: #F5F5F5;" |Normal/'''↑'''
-|style="background: #F5F5F5; padding: 5px;" |
+| rowspan="5" align="center" style="padding: 5px 5px; background: #F5F5F5;" |Normal
-|style="background: #F5F5F5; padding: 5px;" |
+| rowspan="5" align="center" style="padding: 5px 5px; background: #F5F5F5;" |Absent**
-|style="background: #F5F5F5; padding: 5px;" |
+| rowspan="5" align="left" style="padding: 5px 5px; background: #F5F5F5;" |
-|style="background: #F5F5F5; padding: 5px;" |
+* History of [[hyperthyroidism]]
-|style="background: #F5F5F5; padding: 5px;" |
+* History of trauma
+*History of drug use, surgery, or radiation
 |-
-|style="background: #DCDCDC; padding: 5px; text-align: center;" |Differential Diagnosis 5
+| align="center" style="background:#DCDCDC;" |Radiation-induced
-|style="background: #F5F5F5; padding: 5px;" |
-|style="background: #F5F5F5; padding: 5px;" |
-|style="background: #F5F5F5; padding: 5px;" |
-|style="background: #F5F5F5; padding: 5px;" |
-|style="background: #F5F5F5; padding: 5px;" |
-|style="background: #F5F5F5; padding: 5px;" |
-|style="background: #F5F5F5; padding: 5px;" |
-|style="background: #F5F5F5; padding: 5px;" |
-|style="background: #F5F5F5; padding: 5px;" |
-|style="background: #F5F5F5; padding: 5px;" |
-|style="background: #F5F5F5; padding: 5px;" |
-|style="background: #F5F5F5; padding: 5px;" |
-|style="background: #F5F5F5; padding: 5px;" |
-|}
-===Use if the above table can not be made===
-{| style="border: 0px; font-size: 90%; margin: 3px; width: 1000px" align=center
-|valign=top|
-|+
-! style="background: #4479BA; width: 200px;" | {{fontcolor|#FFF|Differential Diagnosis}}
-! style="background: #4479BA; width: 300px;" | {{fontcolor|#FFF|Similar Features}}
-! style="background: #4479BA; width: 300px;" | {{fontcolor|#FFF|Differentiating Features}}
 |-
-| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;"|Differential 1
+| align="center" style="background:#DCDCDC;" |Trauma induced
-| style="padding: 5px 5px; background: #F5F5F5;"|
-* On [physical exam; history; diagnostic test; imaging], [Differential 1] {has; demonstrates} [feature 1], [feature 2], [feature 3] also observed in [disease name].
-| style="padding: 5px 5px; background: #F5F5F5;"|
-* On [physical exam; history; diagnostic test; imaging], [Differential 1] {has; demonstrates} [feature 1], [feature 2], [feature 3] that distinguish it from [disease name].
 |-
-| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;"|Differential 2
+| align="center" style="background:#DCDCDC;" |[[Iodine-131|Radioiodine]] induced
-| style="padding: 5px 5px; background: #F5F5F5;"|
-* On [physical exam; history; diagnostic test; imaging], [Differential 1] {has; demonstrates} [feature 1], [feature 2], [feature 3] also observed in [disease name].
-| style="padding: 5px 5px; background: #F5F5F5;"|
-* On [physical exam; history; diagnostic test; imaging], [Differential 1] {has; demonstrates} [feature 1], [feature 2], [feature 3] that distinguish it from [disease name].
 |-
-| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;"|Differential 3
+| align="center" style="background:#DCDCDC;" |Thyroidectomy
-| style="padding: 5px 5px; background: #F5F5F5;"|
-* On [physical exam; history; diagnostic test; imaging], [Differential 1] {has; demonstrates} [feature 1], [feature 2], [feature 3] also observed in [disease name].
-| style="padding: 5px 5px; background: #F5F5F5;"|
-* On [physical exam; history; diagnostic test; imaging], [Differential 1] {has; demonstrates} [feature 1], [feature 2], [feature 3] that distinguish it from [disease name].
 |-
-| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;"|Differential 4
+| align="center" style="background:#DCDCDC;" |Subclinical [[hypothyroidism]]
-| style="padding: 5px 5px; background: #F5F5F5;"|
+| align="center" style="padding: 5px 5px; background: #F5F5F5;" | -
-* On [physical exam; history; diagnostic test; imaging], [Differential 1] {has; demonstrates} [feature 1], [feature 2], [feature 3] also observed in [disease name].
+| align="center" style="padding: 5px 5px; background: #F5F5F5;" | -
-| style="padding: 5px 5px; background: #F5F5F5;"|
+| align="center" style="padding: 5px 5px; background: #F5F5F5;" |'''↑'''
-* On [physical exam; history; diagnostic test; imaging], [Differential 1] {has; demonstrates} [feature 1], [feature 2], [feature 3] that distinguish it from [disease name].
+| align="center" style="padding: 5px 5px; background: #F5F5F5;" |Normal
+| align="center" style="padding: 5px 5px; background: #F5F5F5;" |Normal
+| align="center" style="padding: 5px 5px; background: #F5F5F5;" |Normal
+| align="center" style="padding: 5px 5px; background: #F5F5F5;" |Normal
+| align="center" style="padding: 5px 5px; background: #F5F5F5;" |Normal
+| align="center" style="padding: 5px 5px; background: #F5F5F5;" |Normal/'''↑'''
+| align="left" style="padding: 5px 5px; background: #F5F5F5;" |
+* Asymptomatic
 |-
-| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;"|Differential 5
-| style="padding: 5px 5px; background: #F5F5F5;"|
-* On [physical exam; history; diagnostic test; imaging], [Differential 1] {has; demonstrates} [feature 1], [feature 2], [feature 3] also observed in [disease name].
-| style="padding: 5px 5px; background: #F5F5F5;"|
-* On [physical exam; history; diagnostic test; imaging], [Differential 1] {has; demonstrates} [feature 1], [feature 2], [feature 3] that distinguish it from [disease name].
 |}
+<br style="clear:left" />''†: T3RU; Triiodothyronine Resin uptake''
+''^: TPOAb; [[Thyroid peroxidase]] antibodies''
+''*: [[TSH]] may be decreased transiently in the [[thyrotoxicosis]]''
+''**: TPOAb may be present in drug-induced [[Hypothyroidism|hypo]]/[[hyperthyroidism]] such as [[Interferon-alpha]], [[Interleukin 2|interleukin-2]], and [[lithium]].''
 ==References==
 {{Reflist|2}}
 {{WH}}
 {{WS}}
+[[Category:Medicine]]
+[[Category:Endocrinology]]
+[[Category:Up-To-Date]]

Riedel's thyroiditis differential diagnosis: Difference between revisions

Latest revision as of 00:01, 30 July 2020

Overview

Differentiating Riedel's Thyroiditis from other Diseases

References

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