Subacute thyroiditis

Overview of subacute thyroiditis (subacute thyroiditis) also known as de Querva in thyroiditis, granulomatous thyroiditis, cytomegalovirus thyroiditis. Pathology Disease Causes : have not yet been fully explained, and is generally believed that the virus infection. Evidence : 1. Patients often before onset of upper respiratory tract infection, the incidence often changes with the seasons, with certain pandemic. 2. Patients with blood virus antibody (antibody titer height and stage of the disease in line), The most common is the Coxsackie virus antibody, followed by adenovirus antibodies, antibody influenza virus, mumps virus antibodies. Although there are reports from patients with subacute thyroiditis the thyroid tissues were isolated mumps virus, But subacute thyroiditis reason is the clear evidence that the virus has not yet been found. Meanwhile, the Chinese, the Japanese subacute thyroiditis and HLA-Bw35 connected, It was suggested that the virus vulnerability with genetic factors, but there are also patients with the HLA-Bw35 irrelevant. Pathology : goiter, texture than real. Plane can still see transparent plastics, which are scattered in the gray lesions. See under the microscope thyroid lesions acinar alternative to the granuloma, a large number of chronic inflammatory cells, cells and swallowing some plastic particles in giant cell formation of nodular lesions similar to tuberculosis, there was a granuloma or cytomegalovirus called thyroiditis. Clinical performance was particularly prevalent in middle-aged women. The incidence is seasonal, as the summer is the peak incidence. Patients often at the onset of upper respiratory tract infection. Typical were the entire stage of the disease can be divided into the early with hyperthyroidism, with the medium-term recovery and Hypothyroidism 3. (1) Early-onset more dramatic, was fever, accompanied by afraid of the cold, shivering, fatigue and loss of appetite inability. The most characteristic of the performance of the thyroid site pain and tenderness, often to the lower jaw, ears or neck after radiotherapy or anywhere, chewing and swallowing pain increased thyroid lesions different, we can start with a leaf, After expanding or transfer to another leaf, or always limited to a leaf. Lesions gland swelling, stiffness, tenderness significant. Extensive lesions, foam thyroid hormone estrogen, as well as non-iodized 1:00 significant quantities of protein release into the blood, Apart from infection so the general performance, but will also associated with the common hyperthyroidism performance. (2) Medium-term acinar when thyroid hormone due to thyroid damage and infection occurred depletion, thyroid cells have not yet been repaired, serum thyroid hormone concentrations can be reduced to the level of hypothyroidism. Clinical can also change the performance of hypothyroidism. (3) recovery symptoms gradually improved, and nodular goiter or gradually disappear, there are many cases, nodules left after the slow absorption. If timely treatment, most patients can be completely restored, become permanent hypothyroidism patients a tiny minority. Mild or not in the typical cases, thyroid only slightly increased, a slight pain and tenderness, fever, systemic symptoms minor, clinical may not have hypothyroidism or hyperthyroidism performance. The disease course vary in length, from a few weeks to more than half a year, normally about two-three months, it said subacute thyroiditis. Condition after remission, it was possible recurrence. For patients with the diagnosis of fever, shortly large goiter with single or multiple nodules, inconsistent and hard notable tenderness. Clinical initially diagnosed the disease. Early laboratory tests increased erythrocyte sedimentation rate, leukocytosis normal or reduced. Serum T3 and T4 increased and decreased blood TSH measured the radioactive iodine uptake rate can be reduced to 5% ~ 10% below. This feature in the diagnosis of the disease is important. Thyroid blood immunoglobulin initially has increased its return to normal thyroid hormone than late. Ultrasonic examination in the diagnosis and judge its active stage is a better method. Ultrasonic imaging tenderness appearing low-density lesion site. Puncture cell or tissue biopsy proved megakaryocyte existence. Treatment of adrenal cortical hormones carbohydrate of the disease a significant effect, 1 ~ medication within 2 days of fever and pain thyroid often rapidly eased, a week after the thyroid often significantly reduced. To be at the beginning of prednisone, three, four times, each time 10 mg qd 1 ~ 2 weeks, weekly decline gradually after 5 mg / d, a wholly-February, after the withdrawal, if relapse, prednisone can rule again, to which may be added with thyroid tablets, particularly hypothyroidism, available daily 40-120mg, several months later, and gradually closed. Antipyretic analgesic such as indomethacin, and other drugs, the disease is effective.