Differentiating Hashimoto's thyroiditis from other diseases: Difference between revisions
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==Differentiating Hashimoto's Thyroiditis from other Diseases== | ==Differentiating Hashimoto's Thyroiditis from other Diseases== | ||
*[[Hashimoto's thyroiditis]] must be differentiated from other causes of [[thyroiditis]], such as [[De Quervain'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> | *[[Hashimoto's thyroiditis]] must be differentiated from other causes of [[thyroiditis]], such as [[De Quervain'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> | ||
<br> | <br><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> | ||
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<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]].'' | <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== | ==References== | ||
Revision as of 01:02, 27 September 2017
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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
Hashimoto's thyroiditis must be differentiated from other causes of thyroiditis, such as De Quervain's thyroiditis, Riedel's thyroiditis, and suppurative thyroiditis.
Differentiating Hashimoto's Thyroiditis from other Diseases
- Hashimoto's thyroiditis must be differentiated from other causes of thyroiditis, such as De Quervain's thyroiditis, Riedel's thyroiditis, and suppurative thyroiditis.[1]
| Conditions | Causes | Age at onset | Pathological findings | Diagnostic approach |
|---|---|---|---|---|
| Hashimoto's thyroiditis |
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| Painful subacute (De Quervain's) thyroiditis |
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| Riedel's thyroiditis |
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| Suppurative thyroiditis |
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- Hashimoto's thyroiditis must be differentiated from other causes of hypothyroidism on the basis of history and symptoms and laboratory findings:[3][4][1][5][6][7]
| Disease | History and symptoms | Laboratory findings | Additional findings | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| Fever | Pain | TSH | Free T4 | T3 | T3RU† | Thyroglobin | TRH | TPOAb^ | |||
| Primary hypothyroidism | Autoimmune (Hashimoto's thyroiditis) | - | - | ↑* | ↓ | N/↓ | N/↓ | N/↑ | N | Present (high titer) |
|
| Riedel's thyroiditis | - | - | N/↑ | N/↓ | N/↓ | N/↓ | N | N | Usually present |
| |
| Infectious thyroiditis | + | + | N | N | N | N | N | N | Absent |
| |
| Transient hypothyroidism | Subacute (de Quervain's) thyroiditis | +/- | +/- | ↓/↑ | ↑/↓ | N | ↓ | ↑ | N | Absent |
|
| Post-partum thyroiditis | +/- | +/- | ↑/↓ | ↓/↑ | N | ↓ | N | N/↑ | Absent |
| |
| Others | Drug-induced | - | - | ↑/↓ | ↓/↑ | N | ↓ | N/↑ | N | Absent** |
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| Radiation-induced | |||||||||||
| Trauma induced | |||||||||||
| Radioiodine induced | |||||||||||
| Thyroidectomy | |||||||||||
| Subclinical hypothyroidism | - | - | ↑ | N | N | N | N | N | N/↑ |
| |
(†)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".
- ↑ Noh JY (2012). "[Silent thyroiditis and subacute thyroiditis]". Nippon Rinsho (in Japanese). 70 (11): 1945–50. PMID 23214066.
- ↑ 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.