Sandbox:DDx HEENT: Difference between revisions

Revision as of 21:15, 1 November 2015

Fatigue, weight gain, cold intolerance, constipation, myopathy, depression, menorrhagia, and infertility

Nontender mild neck swelling Puffy face, bradycardia, and dry skin

Decreased T3/T4 and increased TSH Anti-thyroid peroxidase antibodies

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-* 30-50 yo women, self limited
+Fatigue, weight gain, cold intolerance, constipation, myopathy, depression,  menorrhagia, and infertility
-* Subacute onset
-* Painful neck swelling with fever, malaise, and fatigue
-* Symptoms of thyrotoxicosis followed by transient hypothyroid symptoms
-* Tender mid-line neck swelling
+Nontender mild neck swelling
+Puffy face, bradycardia, and dry skin
+Decreased T3/T4 and increased TSH
-* Initial increase in T3 and T4 with decreased TSH
+Anti-thyroid peroxidase antibodies
-* Followed by decrease in T3 and T4 with increased TSH
-* Return to normal baseline thyroid function
-* Poorly defined hypechogenic region on U/S
-* Decreased vascularity in the affected areas
-* Low uptake thyroid iodine scan
-* Accumulation of neutrophils with follicular destruction and colloid depletion
-* Noncaseating granulomas formation
-* Fibrosis may develop
-* HLA-B35