Silent thyroiditis diagnostic criteria
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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. Histopathological is also important to differentiate silent thyroiditis from other forms of thyroiditis.[1][2][3]
- Elevated serum T4, T3 in thyrotoxicosis
- Elevated thyroglobulin concentrations
- Decreased RAIU (Radioactive iodine uptake)
- Histopathological findings include:
- Lymphocytic infiltration
- The Absence of following:
- Hurthle cells
- Germinal centers
- Fibrosis
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 | Hashimoto's thyroiditis | Increased | Decreased | Hashimoto's thyroiditis | Riedel's thyroiditis†† | ||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Graves disease† | Silent thyroiditis
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‡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.
Table modified from [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".