What is thyroiditis and how is it diagnosed?

Updated: Aug 19, 2020
  • Author: Daniel J Kelley, MD; Chief Editor: Arlen D Meyers, MD, MBA  more...
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Diagnosis of thyroiditis includes 5 disorders. Hashimoto thyroiditis is an autoimmune disease; principal manifestations are goiter and hypothyroidism. Subacute granulomatous thyroiditis is probably viral in origin, and patients usually present with a tender goiter. Subacute lymphocytic thyroiditis is of unknown pathogenesis, but the postpartum form may be autoimmune. Its principal manifestations are goiter and spontaneously reversible hyperthyroidism.

Acute suppurative thyroiditis results from bacterial or fungal infection causing abscess. Riedel struma, a disease of unknown cause, manifests with a goiter and thoracic inlet obstruction. The presence of clinical or metabolic hyperthyroidism in combination with painful nodular thyroid disease strongly suggests thyroiditis as a potential diagnosis. Local abscess is usually infectious, but it may develop from necrotic undifferentiated thyroid carcinoma. Infectious etiologies include bacterial, viral, fungal, and parasitic sources, or it could be the result of piriform sinus fistula.

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