Silent thyroiditis diagnostic criteria: Difference between revisions
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==Diagnostic Criteria== | ==Diagnostic Criteria== | ||
There are no established criteria for the diagnosis of silent thyroiditis. Decreased [[radioactive iodine]] uptake, elevated serum [[T3]], and [[T4]] are helpful in diagnosing silent thyroiditis. | There are no established criteria for the diagnosis of silent thyroiditis. Decreased [[radioactive iodine]] uptake, elevated serum [[T3]], and [[T4]] are helpful in diagnosing silent thyroiditis. Histopathology is also important to differentiate silent thyroiditis from other forms of [[thyroiditis]].<ref name="pmid21278944">{{cite journal |vauthors=Walker P |title=Silent thyroiditis |journal=Can Fam Physician |volume=30 |issue= |pages=1337–9 |year=1984 |pmid=21278944 |pmc=2153523 |doi= |url=}}</ref><ref name="pmid22443972">{{cite journal |vauthors=Samuels MH |title=Subacute, silent, and postpartum thyroiditis |journal=Med. Clin. North Am. |volume=96 |issue=2 |pages=223–33 |year=2012 |pmid=22443972 |doi=10.1016/j.mcna.2012.01.003 |url=}}</ref><ref name="pmid23214066">{{cite journal |vauthors=Noh JY |title=[Silent thyroiditis and subacute thyroiditis] |language=Japanese |journal=Nippon Rinsho |volume=70 |issue=11 |pages=1945–50 |year=2012 |pmid=23214066 |doi= |url=}}</ref> | ||
*Elevated serum [[T4]] | *Elevated serum [[T4]] and [[T3]] '''in thyrotoxicosis''' | ||
*Elevated [[thyroglobulin]] concentrations | *Elevated [[thyroglobulin]] concentrations | ||
*Decreased [[Radioactive iodine|RAIU | *Decreased [[Radioactive iodine uptake|RAIU (Radioactive iodine uptake)]] | ||
*Histopathological findings include: | *[[Histopathological]] findings include: | ||
**[[Lymphocytic]] infiltration | **[[Lymphocytic]] infiltration | ||
**The '''Absence''' of following: | **The '''Absence''' of following: | ||
***Hurthle cells | ***[[Hurthle cells]] | ||
***[[Germinal centers]] | ***[[Germinal centers]] | ||
***[[Fibrosis]] | ***[[Fibrosis]] | ||
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{{familytree/end}} | {{familytree/end}} | ||
<small>‡TFT; Thyroid function tests(TSH, T4, and T3), †[[Grave's disease]] is not a thyroiditis, *RAIU; Radioiodine uptake.††One third of [[Riedel's thyroiditis]] presents with [[hypothyroidism]].</small> | <small>‡TFT; [[Thyroid function tests]]([[TSH]], [[T4]], and [[T3]]), †[[Grave's disease]] is not a thyroiditis, *RAIU; [[Radioiodine|Radioiodin]]<nowiki/>e uptake.</small> | ||
<small> | |||
<small>††One third of [[Riedel's thyroiditis]] presents with [[hypothyroidism]].</small><small> <ref name="urlThyroiditis: Differential Diagnosis and Management - American Family Physician">{{cite web |url=http://www.aafp.org/afp/2000/0215/p1047.html#afp20000215p1047-b7 |title=Thyroiditis: Differential Diagnosis and Management - American Family Physician |format= |work= |accessdate=}}</ref></small> | |||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
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{{WH}} | {{WH}} | ||
{{WS}} | {{WS}} | ||
[[Category:Medicine]] | |||
[[Category:Endocrinology]] | |||
[[Category:Up-To-Date]] | |||
Latest revision as of 00:11, 30 July 2020
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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
There are no established criteria for the diagnosis of silent thyroiditis. Decreased radioactive iodine uptake, elevated serum T3, and T4 are helpful in diagnosing silent thyroiditis. Histopathology is also important to differentiate silent thyroiditis from other forms of thyroiditis.
Diagnostic Criteria
There are no established criteria for the diagnosis of silent thyroiditis. Decreased radioactive iodine uptake, elevated serum T3, and T4 are helpful in diagnosing silent thyroiditis. Histopathology is also important to differentiate silent thyroiditis from other forms of thyroiditis.[1][2][3]
- Elevated serum T4 and T3 in thyrotoxicosis
- Elevated thyroglobulin concentrations
- Decreased RAIU (Radioactive iodine uptake)
- Histopathological findings include:
- Lymphocytic infiltration
- The Absence of following:
Stepwise clinical diagnosis of Silent thyroiditis
The following flowchart describes the clinical approach to the diagnosis of silent thyroiditis.
| Neck pain | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Yes | No | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| RAIU* | Presenting symptoms and TFTs‡ | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Increased | Decreased | Hyperthyroid | Hypothyroid | Euthyroid | |||||||||||||||||||||||||||||||||||||||||||||||||||||||
| RAIU* | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Suppurative thyroiditis | De Quervain's thyroiditis | Increased | Decreased | Hashimoto's thyroiditis | Riedel's thyroiditis†† | ||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Grave's disease† | Silent thyroiditis
Postpartum thyroiditis | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
‡TFT; Thyroid function tests(TSH, T4, and T3), †Grave's disease is not a thyroiditis, *RAIU; Radioiodine uptake.
††One third of Riedel's thyroiditis presents with hypothyroidism. [4]
References
- ↑ Walker P (1984). "Silent thyroiditis". Can Fam Physician. 30: 1337–9. PMC 2153523. PMID 21278944.
- ↑ Samuels MH (2012). "Subacute, silent, and postpartum thyroiditis". Med. Clin. North Am. 96 (2): 223–33. doi:10.1016/j.mcna.2012.01.003. PMID 22443972.
- ↑ Noh JY (2012). "[Silent thyroiditis and subacute thyroiditis]". Nippon Rinsho (in Japanese). 70 (11): 1945–50. PMID 23214066.
- ↑ "Thyroiditis: Differential Diagnosis and Management - American Family Physician".