Thyroiditis: An Integrated Approach
Thyroiditis is a general term that encompasses several clinical disorders characterized by inflammation of the thyroid gland. The most common is Hashimoto thyroiditis; patients typically present with a nontender goiter, hypothyroidism, and an elevated thyroid peroxidase antibody level. Treatment wit...
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| Veröffentlicht in: | American family physician 2014-09, Vol.90 (6), p.389-396 |
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| description | Thyroiditis is a general term that encompasses several clinical disorders characterized by inflammation of the thyroid gland. The most common is Hashimoto thyroiditis; patients typically present with a nontender goiter, hypothyroidism, and an elevated thyroid peroxidase antibody level. Treatment with levothyroxine ameliorates the hypothyroidism and may reduce goiter size. Postpartum thyroiditis is transient or persistent thyroid dysfunction that occurs within one year of childbirth, miscarriage, or medical abortion. Release of preformed thyroid hormone into the bloodstream may result in hyperthyroidism. This may be followed by transient or permanent hypothyroidism as a result of depletion of thyroid hormone stores and destruction of thyroid hormone-producing cells. Patients should be monitored for changes in thyroid function. Beta blockers can treat symptoms in the initial hyperthyroid phase; in the subsequent hypothyroid phase, levothyroxine should be considered in women with a serum thyroid-stimulating hormone level greater than 10 mIU per L, or in women with a thyroid-stimulating hormone level of 4 to 10 mIU per L who are symptomatic or desire fertility. Subacute thyroiditis is a transient thyrotoxic state characterized by anterior neck pain, suppressed thyroid-stimulating hormone, and low radioactive iodine uptake on thyroid scanning. Many cases of subacute thyroiditis follow an upper respiratory viral illness, which is thought to trigger an inflammatory destruction of thyroid follicles. In most cases, the thyroid gland spontaneously resumes normal thyroid hormone production after several months. Treatment with high-dose acetylsalicylic acid or nonsteroidal anti-inflammatory drugs is directed toward relief of thyroid pain. |
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The most common is Hashimoto thyroiditis; patients typically present with a nontender goiter, hypothyroidism, and an elevated thyroid peroxidase antibody level. Treatment with levothyroxine ameliorates the hypothyroidism and may reduce goiter size. Postpartum thyroiditis is transient or persistent thyroid dysfunction that occurs within one year of childbirth, miscarriage, or medical abortion. Release of preformed thyroid hormone into the bloodstream may result in hyperthyroidism. This may be followed by transient or permanent hypothyroidism as a result of depletion of thyroid hormone stores and destruction of thyroid hormone-producing cells. Patients should be monitored for changes in thyroid function. Beta blockers can treat symptoms in the initial hyperthyroid phase; in the subsequent hypothyroid phase, levothyroxine should be considered in women with a serum thyroid-stimulating hormone level greater than 10 mIU per L, or in women with a thyroid-stimulating hormone level of 4 to 10 mIU per L who are symptomatic or desire fertility. Subacute thyroiditis is a transient thyrotoxic state characterized by anterior neck pain, suppressed thyroid-stimulating hormone, and low radioactive iodine uptake on thyroid scanning. Many cases of subacute thyroiditis follow an upper respiratory viral illness, which is thought to trigger an inflammatory destruction of thyroid follicles. In most cases, the thyroid gland spontaneously resumes normal thyroid hormone production after several months. Treatment with high-dose acetylsalicylic acid or nonsteroidal anti-inflammatory drugs is directed toward relief of thyroid pain.</description><identifier>ISSN: 0002-838X</identifier><identifier>EISSN: 1532-0650</identifier><identifier>PMID: 25251231</identifier><language>eng</language><publisher>United States: American Academy of Family Physicians</publisher><subject>Abscesses ; Adrenergic beta-Antagonists - therapeutic use ; Airway management ; Antibodies ; Beta blockers ; Drug dosages ; Dysphagia ; Endocrinology ; Female ; Goiter ; Graves disease ; Hormone Replacement Therapy - methods ; Humans ; Hyperthyroidism ; Hypothyroidism ; Hypothyroidism - diagnosis ; Hypothyroidism - drug therapy ; Hypothyroidism - etiology ; Hypothyroidism - physiopathology ; Internal Medicine ; Iodine ; Kidney cancer ; Laboratories ; Leukemia ; Lymphoma ; Male ; Melanoma ; Monitoring, Physiologic - methods ; Neck pain ; Nonsteroidal anti-inflammatory drugs ; Patients ; Pregnancy ; Pregnancy Complications - diagnosis ; Pregnancy Complications - drug therapy ; Pregnancy Complications - metabolism ; Pregnancy Complications - physiopathology ; Prognosis ; Skin cancer ; Thyroid gland ; Thyroid Gland - diagnostic imaging ; Thyroid Gland - metabolism ; Thyroiditis - classification ; Thyroiditis - diagnosis ; Thyroiditis - drug therapy ; Thyroiditis - metabolism ; Thyroiditis - physiopathology ; Thyrotropin - blood ; Thyroxine - metabolism ; Thyroxine - therapeutic use ; Treatment Outcome ; Ultrasonography</subject><ispartof>American family physician, 2014-09, Vol.90 (6), p.389-396</ispartof><rights>American Family Physician</rights><rights>Copyright American Academy of Family Physicians Sep 15, 2014</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>315,782,786</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25251231$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Sweeney, Lori B., MD</creatorcontrib><creatorcontrib>Stewart, Christopher, MD</creatorcontrib><creatorcontrib>Gaitonde, David Y., MD</creatorcontrib><title>Thyroiditis: An Integrated Approach</title><title>American family physician</title><addtitle>Am Fam Physician</addtitle><description>Thyroiditis is a general term that encompasses several clinical disorders characterized by inflammation of the thyroid gland. The most common is Hashimoto thyroiditis; patients typically present with a nontender goiter, hypothyroidism, and an elevated thyroid peroxidase antibody level. Treatment with levothyroxine ameliorates the hypothyroidism and may reduce goiter size. Postpartum thyroiditis is transient or persistent thyroid dysfunction that occurs within one year of childbirth, miscarriage, or medical abortion. Release of preformed thyroid hormone into the bloodstream may result in hyperthyroidism. This may be followed by transient or permanent hypothyroidism as a result of depletion of thyroid hormone stores and destruction of thyroid hormone-producing cells. Patients should be monitored for changes in thyroid function. Beta blockers can treat symptoms in the initial hyperthyroid phase; in the subsequent hypothyroid phase, levothyroxine should be considered in women with a serum thyroid-stimulating hormone level greater than 10 mIU per L, or in women with a thyroid-stimulating hormone level of 4 to 10 mIU per L who are symptomatic or desire fertility. Subacute thyroiditis is a transient thyrotoxic state characterized by anterior neck pain, suppressed thyroid-stimulating hormone, and low radioactive iodine uptake on thyroid scanning. Many cases of subacute thyroiditis follow an upper respiratory viral illness, which is thought to trigger an inflammatory destruction of thyroid follicles. In most cases, the thyroid gland spontaneously resumes normal thyroid hormone production after several months. Treatment with high-dose acetylsalicylic acid or nonsteroidal anti-inflammatory drugs is directed toward relief of thyroid pain.</description><subject>Abscesses</subject><subject>Adrenergic beta-Antagonists - therapeutic use</subject><subject>Airway management</subject><subject>Antibodies</subject><subject>Beta blockers</subject><subject>Drug dosages</subject><subject>Dysphagia</subject><subject>Endocrinology</subject><subject>Female</subject><subject>Goiter</subject><subject>Graves disease</subject><subject>Hormone Replacement Therapy - methods</subject><subject>Humans</subject><subject>Hyperthyroidism</subject><subject>Hypothyroidism</subject><subject>Hypothyroidism - diagnosis</subject><subject>Hypothyroidism - drug therapy</subject><subject>Hypothyroidism - etiology</subject><subject>Hypothyroidism - physiopathology</subject><subject>Internal Medicine</subject><subject>Iodine</subject><subject>Kidney cancer</subject><subject>Laboratories</subject><subject>Leukemia</subject><subject>Lymphoma</subject><subject>Male</subject><subject>Melanoma</subject><subject>Monitoring, Physiologic - methods</subject><subject>Neck pain</subject><subject>Nonsteroidal anti-inflammatory drugs</subject><subject>Patients</subject><subject>Pregnancy</subject><subject>Pregnancy Complications - diagnosis</subject><subject>Pregnancy Complications - drug therapy</subject><subject>Pregnancy Complications - metabolism</subject><subject>Pregnancy Complications - physiopathology</subject><subject>Prognosis</subject><subject>Skin cancer</subject><subject>Thyroid gland</subject><subject>Thyroid Gland - diagnostic imaging</subject><subject>Thyroid Gland - metabolism</subject><subject>Thyroiditis - classification</subject><subject>Thyroiditis - diagnosis</subject><subject>Thyroiditis - drug therapy</subject><subject>Thyroiditis - metabolism</subject><subject>Thyroiditis - physiopathology</subject><subject>Thyrotropin - blood</subject><subject>Thyroxine - metabolism</subject><subject>Thyroxine - therapeutic use</subject><subject>Treatment Outcome</subject><subject>Ultrasonography</subject><issn>0002-838X</issn><issn>1532-0650</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNpdkEtLAzEUhYMotlb_ghS6cTOQm9dMXAil-CgUXFjBXcgktzZ1OlMnM0L_vSlWF64OFz7OPeeckCFIzjKqJD0lQ0opywpevA3IRYybdOYS9DkZMMkkMA5DMlmu920TfOhCvB1P6_G87vC9tR368XS3axvr1pfkbGWriFdHHZHXh_vl7ClbPD_OZ9NFhkyLLnOuAGtLWhYFoufocg-udKq0ChCVzP2Kae68Yp567hkFcGC10rQQXOWaj8jNj296-9lj7Mw2RIdVZWts-mhAKgUgcsESOvmHbpq-rVM6w4QUgoJWIlHXR6ovt-jNrg1b2-7Nb_0E3P0AmGp9BWyNq0IdnK0-cI_xzxNMZIaal8Oghz1BKMpBCv4NKDFp1w</recordid><startdate>20140915</startdate><enddate>20140915</enddate><creator>Sweeney, Lori B., MD</creator><creator>Stewart, Christopher, MD</creator><creator>Gaitonde, David Y., MD</creator><general>American Academy of Family Physicians</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88C</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>M0R</scope><scope>M0S</scope><scope>M0T</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20140915</creationdate><title>Thyroiditis: An Integrated Approach</title><author>Sweeney, Lori B., MD ; Stewart, Christopher, MD ; Gaitonde, David Y., MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-e294t-cc81aab0b88eed3ec7d1cbc6ba61ee657df293cd62d0d3d2011c1a96908436793</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Abscesses</topic><topic>Adrenergic beta-Antagonists - therapeutic use</topic><topic>Airway management</topic><topic>Antibodies</topic><topic>Beta blockers</topic><topic>Drug dosages</topic><topic>Dysphagia</topic><topic>Endocrinology</topic><topic>Female</topic><topic>Goiter</topic><topic>Graves disease</topic><topic>Hormone Replacement Therapy - methods</topic><topic>Humans</topic><topic>Hyperthyroidism</topic><topic>Hypothyroidism</topic><topic>Hypothyroidism - diagnosis</topic><topic>Hypothyroidism - drug therapy</topic><topic>Hypothyroidism - etiology</topic><topic>Hypothyroidism - physiopathology</topic><topic>Internal Medicine</topic><topic>Iodine</topic><topic>Kidney cancer</topic><topic>Laboratories</topic><topic>Leukemia</topic><topic>Lymphoma</topic><topic>Male</topic><topic>Melanoma</topic><topic>Monitoring, Physiologic - methods</topic><topic>Neck pain</topic><topic>Nonsteroidal anti-inflammatory drugs</topic><topic>Patients</topic><topic>Pregnancy</topic><topic>Pregnancy Complications - diagnosis</topic><topic>Pregnancy Complications - drug therapy</topic><topic>Pregnancy Complications - metabolism</topic><topic>Pregnancy Complications - physiopathology</topic><topic>Prognosis</topic><topic>Skin cancer</topic><topic>Thyroid gland</topic><topic>Thyroid Gland - diagnostic imaging</topic><topic>Thyroid Gland - metabolism</topic><topic>Thyroiditis - classification</topic><topic>Thyroiditis - diagnosis</topic><topic>Thyroiditis - drug therapy</topic><topic>Thyroiditis - metabolism</topic><topic>Thyroiditis - physiopathology</topic><topic>Thyrotropin - blood</topic><topic>Thyroxine - metabolism</topic><topic>Thyroxine - therapeutic use</topic><topic>Treatment Outcome</topic><topic>Ultrasonography</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Sweeney, Lori B., MD</creatorcontrib><creatorcontrib>Stewart, Christopher, MD</creatorcontrib><creatorcontrib>Gaitonde, David Y., MD</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Healthcare Administration Database (Alumni)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Healthcare Administration Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>American family physician</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Sweeney, Lori B., MD</au><au>Stewart, Christopher, MD</au><au>Gaitonde, David Y., MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Thyroiditis: An Integrated Approach</atitle><jtitle>American family physician</jtitle><addtitle>Am Fam Physician</addtitle><date>2014-09-15</date><risdate>2014</risdate><volume>90</volume><issue>6</issue><spage>389</spage><epage>396</epage><pages>389-396</pages><issn>0002-838X</issn><eissn>1532-0650</eissn><abstract>Thyroiditis is a general term that encompasses several clinical disorders characterized by inflammation of the thyroid gland. The most common is Hashimoto thyroiditis; patients typically present with a nontender goiter, hypothyroidism, and an elevated thyroid peroxidase antibody level. Treatment with levothyroxine ameliorates the hypothyroidism and may reduce goiter size. Postpartum thyroiditis is transient or persistent thyroid dysfunction that occurs within one year of childbirth, miscarriage, or medical abortion. Release of preformed thyroid hormone into the bloodstream may result in hyperthyroidism. This may be followed by transient or permanent hypothyroidism as a result of depletion of thyroid hormone stores and destruction of thyroid hormone-producing cells. Patients should be monitored for changes in thyroid function. Beta blockers can treat symptoms in the initial hyperthyroid phase; in the subsequent hypothyroid phase, levothyroxine should be considered in women with a serum thyroid-stimulating hormone level greater than 10 mIU per L, or in women with a thyroid-stimulating hormone level of 4 to 10 mIU per L who are symptomatic or desire fertility. Subacute thyroiditis is a transient thyrotoxic state characterized by anterior neck pain, suppressed thyroid-stimulating hormone, and low radioactive iodine uptake on thyroid scanning. Many cases of subacute thyroiditis follow an upper respiratory viral illness, which is thought to trigger an inflammatory destruction of thyroid follicles. In most cases, the thyroid gland spontaneously resumes normal thyroid hormone production after several months. Treatment with high-dose acetylsalicylic acid or nonsteroidal anti-inflammatory drugs is directed toward relief of thyroid pain.</abstract><cop>United States</cop><pub>American Academy of Family Physicians</pub><pmid>25251231</pmid><tpages>8</tpages></addata></record> |
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| subjects | Abscesses Adrenergic beta-Antagonists - therapeutic use Airway management Antibodies Beta blockers Drug dosages Dysphagia Endocrinology Female Goiter Graves disease Hormone Replacement Therapy - methods Humans Hyperthyroidism Hypothyroidism Hypothyroidism - diagnosis Hypothyroidism - drug therapy Hypothyroidism - etiology Hypothyroidism - physiopathology Internal Medicine Iodine Kidney cancer Laboratories Leukemia Lymphoma Male Melanoma Monitoring, Physiologic - methods Neck pain Nonsteroidal anti-inflammatory drugs Patients Pregnancy Pregnancy Complications - diagnosis Pregnancy Complications - drug therapy Pregnancy Complications - metabolism Pregnancy Complications - physiopathology Prognosis Skin cancer Thyroid gland Thyroid Gland - diagnostic imaging Thyroid Gland - metabolism Thyroiditis - classification Thyroiditis - diagnosis Thyroiditis - drug therapy Thyroiditis - metabolism Thyroiditis - physiopathology Thyrotropin - blood Thyroxine - metabolism Thyroxine - therapeutic use Treatment Outcome Ultrasonography |
| title | Thyroiditis: An Integrated Approach |
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