Thyroiditis

General characteristic of a disease

Thyroiditis – this whole group of diseases of various etiology with one general sign – inflammatory process of tissues of thyroid gland. It is accepted to distinguish 4 main forms of a tireodit:

• autoimmune thyroiditis or chronic thyroiditis of Hashimoto;
• acute thyroiditis which in turn can be purulent or not purulent;
• subacute thyroiditis or de Querven's thyroiditis
• and asymptomatic thyroiditis.

Each of forms of a disease needs specific treatment.

Autoimmune thyroiditis of a chronic form

The autoimmune thyroiditis results from destruction of follicular cells of a thyroid gland. This process develops because of genetic defect of an immune response of an organism on own thyrocytes. At patients with an autoimmune thyroiditis of a chronic form in blood antibodies to cells of a thyroid gland circulate.

The disease is quite often combined with others autoimmunno the caused diseases: primary hypocorticoidism, hepatitis, a diabetes mellitus, a pseudorheumatism also has high risk (to 70%) to be complicated by development of a hypothyroidism (deficit of thyroid hormones).

The euthyroid asymptomatic phase of a chronic thyroiditis can proceed decades. In this regard it is difficult to establish exact percent of occurrence of a disease. With the diagnosed autoimmune thyroiditis of an antibody to cells of a thyroid gland are diagnosed for relatives of patients in 50% of cases.

Among symptoms of a thyroiditis of an autoimmune form in a subclinical and clinical stage call:

• the increased volume of a thyroid gland,
• discomfort in a thyroid gland,
• the complicated swallowing,
• morbidity at a palpation,
• weakness,
• joint pain.

At the chronic thyroiditis complicated by a hypothyroidism at the patient are shown:

• shiver of fingers of hands,
• tachycardia,
• perspiration,
• hypertensia.

The special form of an autoimmune thyroiditis is represented by a postnatal thyroiditis. It is observed in 5-9% of all cases of pregnancies. Symptoms of a thyroiditis of this form usually pass without treatment within a year after the delivery.

Subacute thyroiditis

The subacute thyroiditis is an inflammation of a thyroid gland of presumably virus origin. The thyroiditis of this form usually develops 2 weeks later after the postponed infection: flu, mumps, measles, etc.

The inflammation of tissues of thyroid gland is shown by the following symptoms of a thyroiditis:

• headache,
• decrease in working capacity,
• feeling of weakness,
• ache in joints and muscles,
• fever,
• fervescence.

Among local symptoms of a thyroiditis of a subacute form call swelled also morbidity of a thyroid gland. Pain can be felt also in a chin, an ear or a nape. Most often the disease is diagnosed for women of 20-50 years. The subacute thyroiditis is diagnosed for men by 5 times less than at women.

Asymptomatic thyroiditis

At this kind of a disease there are no specific symptoms of a thyroiditis. The only symptom of pathology is small increase in the sizes of a thyroid gland. In several weeks the inflammation independently passes, and the size of body is returned to norm. In time a tranzitorny enlargement of the thyroid gland in an organism of the patient the level of thyroid hormones increases.

The asymptomatic thyroiditis has high probability of a recurrence. The nature of its origin is not studied by medicine.

Acute thyroiditis

Acute thyroiditis – the most rare form of a disease. Emergence of purulent or not purulent inflammatory process of tissues of thyroid gland is provoked by the infection caused by tonsillitis, pneumonia or sepsis. Not purulent acute thyroiditis can also result from an injury of a thyroid gland or beam radiation.

Carry to symptoms of a tireodit of an acute form:

• consolidation of a thyroid gland,
• emergence of abscess,
• sharp temperature increase to 40 degrees,
• tachycardia,
• pain in the lower part of the head,
• symptoms of intoxication of an organism.

At an untimely initiation of treatment of a tireodit of an acute form the disease can result in irreversible insufficiency of a thyroid gland.

Diagnosis of a tireodit

The diagnosis "an autoimmune thyroiditis of a chronic form" is confirmed in case of detection at the patient big quantities of antibodies to cells of a thyroid gland. For installation of the final diagnosis "the chronic thyroiditis" is required carrying out a biopsy of a thyroid gland.

The subacute thyroiditis is diagnosed on the basis of complaints of the patient to pain in a thyroid gland and morbidity of swallowing. In the anamnesis at the patient at the same time the case of the recent postponed infection has to be recorded. It is possible to confirm the diagnosis "a subacute thyroiditis" by means of ultrasonography and Krayl's test. The last represents administration of Prednisolonum and control over a condition of the patient. At a subacute thyroiditis the daily dose of Prednisolonum (30 mg) significantly facilitates health of the patient.

At an asymptomatic thyroiditis in blood of the patient a large amount of thyroid hormones and low level of absorption is diagnosed by a thyroid gland of a radioiodine.

In diagnosis of an acute thyroiditis studying of composition of blood is also applied. At this form of a disease the high level of leukocytes and increase in SOE is found. The amount of thyroid hormones is usually not changed. Visually the site of a softening of a thyroid gland decides on the created abscess center.

Treatment of a tireodit

The effective treatment of a tireodit of an autoimmune form guaranteeing healing of the patient at the moment is not developed. The standard of treatment of a tireodit of a chronic form is lifelong replacement therapy by thyroid means, for example, L-thyroxine.

Thanks to reception of artificial hormones of a thyroid gland it is possible to reduce the sizes of a craw and to prevent a further hypertrophy of fabrics of body. The postnatal autoimmune thyroiditis, as a rule, does not need treatment. An exception cases of a chronic thyroiditis of this version duration make year and more.

In treatment of a thyroiditis of a subacute form glucocorticoids, for example, Prednisolonum are widely applied. It promotes removal of hypostasis of a thyroid gland. Duration of therapy is especially individual.

In treatment of a thyroiditis of an acute purulent form antibiotics and antihistaminic drugs are used. At the same time in the conditions of a hospital intravenous drop administration of saline solutions is carried out, plentiful drink for reduction of the general intoxication of an organism is appointed.

In the presence of abscess treatment of a thyroiditis surgical. It consists in opening and drainage of a suppurative focus. If in time not to remove abscess, its spontaneous disclosure and hit of pus in a mediastinum or the patient's trachea is possible. At adequate treatment of a thyroiditis of an acute form recovery occurs within 1-2 months.