Thyroiditis subacute

Treatment of thyroiditis (Hashimoto s thyroiditis, subacute thyroiditis of de Quervain). Where hyperthyroidism is a feature, treatment is by a P-adrenoceptor blocking drug. Antithyroid drugs should not be used. Where there is permanent hypothyroidism, the treatment is thyroid hormone replacement. 

The health effects of sorbic acid and sorbates have been reviewed (165—167). The extremely low toxicity of sorbic acid enhances its desirabiHty as a food preservative. The oral LD q for sorbic acid in rats is 7—10 g/kg body weight compared to 5 g/kg for sodium chloride (165—169). In subacute and chronic toxicity tests in rats, 5% sorbic acid in the diet results in no abnormal effects after 90 days or lifetime feeding studies. A level of 10% in rat diets results in a slight enlargement of the Hver, kidneys, and thyroid gland (170). This same dietary level fed to mice also resulted in an increase in Hver and kidney weight... 

Iodine excess (including radiocontrast, amiodarone) Thyrotoxicosis without hyperthyroidism Subacute thyroiditis Silent (painless) thyroiditis... 

Painful subacute (granulomatous or de Quervain s) thyroiditis is believed to be caused by viral invasion of thyroid parenchyma. 

In subacute thyroiditis, patients complain of severe pain in the thyroid region, which often extends to the ear on the affected side. Low-grade fever... 

Painless thyroiditis has a triphasic course that mimics that of painful subacute thyroiditis. Most patients present with mild thyrotoxic symptoms lid retraction and lid lag are present but exophthalmos is absent. The thyroid gland may be diffusely enlarged, but thyroid tenderness is absent. 

A low RAIU indicates the excess thyroid hormone is not a consequence of thyroid gland hyperfunction. This may be seen in painful subacute thyroiditis, painless thyroiditis, struma ovarii, follicular cancer, and factitious ingestion of exogenous thyroid hormone. 

In subacute thyroiditis, thyroid function tests typically run a triphasic course in this self-limited disease. Initially, serum T4 levels are elevated due to release of preformed thyroid hormone from disrupted follicles. The 24-hour RAIU during this time is less than 2% because of thyroid inflammation and TSH suppression by the elevated T4 level. As the disease progresses, intrathyroidal hormone stores are depleted, and the patient may become mildly hypothyroid with an appropriately elevated TSH level. During the recovery phase, thyroid hormone stores are replenished and serum TSH elevation gradually returns to normal. 

Hypothyroidism As replacement or supplemental therapy in hypothyroidism of any etiology, except transient hypothyroidism during the recovery phase of subacute thyroiditis. 

Pituitary TSH suppressants In the treatment or prevention of various types of euthyroid goiters, including thyroid nodules, subacute, or chronic lymphocytic thyroiditis (Hashimoto), multinodular goiter, and in the management of thyroid cancer (except liothyronine). 

Secondary to the societal concerns around chemical-related endocrine disruption, the OECD407 subacute 28-day toxicity study protocol has been updated in 2007 with parameters relating to endocrine homeostasis. Specifically, circulating thyroid hormones and detailed assessment of reproductive organ parameters were added to the protocol. Reproductive hormones were suggested as additional parameters but they were deemed not informative in view of their large variability in untreated animals. 

Thyroid diseases Malignant exophthalmos, subacute thyroiditis... 

Collins WT, Capen CC, Garthoff LH, et al. 1978. Comparative toxicity of polychlorinated biphenyl and polybrominated biphenyl in the rat thyroid gland light and electron microscopic alterations after subacute dietary exposure. J Environ Pathol Toxicol 1 587-599. 

A middle-aged woman developed subacute thyroiditis by the sixth month of treatment with interferon alfa (508). She also had the classic symptoms of hyperthyroidism, although it is clear that these could easily have been mistaken for adverse effects of interferon alfa itself, for example weakness, weight loss, and palpitation. 

A 30-year-old man, who had taken lithium for 16 years for bipolar disorder and long-term ciclosporin and prednisolone after a bone-marrow transplant, developed subacute thyroiditis associated with a diffusely enlarged gland that showed heterogeneous echogenicity, but without a clear relation to lithium (650). 

Cinar T. Subacute thyroiditis in a patient with chronic hepatitis C during interferon treatment a case report. Ondokuz Mayis Univ Tip Derg 1999 16 62-6. 

Obuobie K, Al-Sabah A, Lazarus JH. Subacute thyroiditis in an immunosuppressed patient. J Endocrinol Invest 2002 25(2) 169-71. 

The treatment of hyperthyroidism due to Graves disease is either 12 months treatment with carbimazole or propylthiouracil or a single diagnosis of 1.These drugs do not have a place in the 5 10% of patients in whom thyrotoyicosis is due to a toyic adenoma or to subacute thyroiditis. 

In a subacute study, both male and female rats were fed diets containing octachlorostyrene at 0.5, 5.0, 50, and 500 mg kg for 28 days. Histological changes were observed in the liver and thyroid of rats exposed to doses equal to or greater than 5 mgkg. Hepatic microsomal enzyme induction and liver hypertrophy were observed in the two highest dose groups. At 500 mg kg there was an increase in... 

A. Acute or subacute thyroiditis (viral or bacterial etiology)... 

Tg is primarily used as a tumor marker in patients carrying a diagnosis of differentiated thyroid carcinoma (DTC). Although serum Tg is elevated in patients with thyroid cancer, including thyroid follicular and papillary carcinoma, elevations are also are seen in nonneoplastic conditions such as thyroid adenoma, subacute thyroiditis, Hashimoto s thyroiditis, and Graves disease. Serum Tg concentrations are not increased in patients with medullary thyroid carcinoma. 

Hontela, A., C. Daniel and A.C. Ricard. Effects of acute and subacute exposures to cadmium on the interrenal and thyroid function in rainbow trout (Oncorhynchus mykiss). Aquat. Toxicol. 35 171-182,1996. 

Painful subacute (viral or deQuervain s) thyroiditis may be caused by viral invasion of thyroid parenchyma. Typically, patients complain of severe pain in the thyroid region, which often extends to the ear on the affected side. With time, the pain may migrate from one side of the gland to the other. Low-grade fever is common. Systemic symptoms owing to thyrotoxicosis are present. On physical examination, the thyroid gland is firm and exquisitely tender. Signs of thyrotoxicosis are present. 

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