Thyroid inflammation - cause and course

Inflammation is one of the rarer diseases of the thyroid gland. Behind the term "thyroiditis" hides an inhomogeneous group of different clinical pictures. However, these have one thing in common: a diffuse or focal inflammatory reaction of the thyroid tissue to an inflammatory stimulus. Thyroid inflammations can be classified according to their cause, their clinical course or their histology, ie the microscopic picture of the thyroid tissue.

When does thyroiditis develop?

  • Acute thyroiditis: It is mostly caused by bacteria that have spread through the bloodstream or lymphatic system. Rarely does this form develop through other infections (tuberculosis, syphilis, fungi), as a result of radiation or certain medications, or on the basis of an autoimmune reaction or injury.
  • Subacute thyroiditis (de Quervain): Triggers are probably viruses, such as measles or mumps infection. The form induced by autoimmune processes after pregnancy (postpartum thyroiditis) is usually subacute.
  • Chronic thyroiditis: It is almost always caused by an autoimmune disease in which the immune system falsely produces antibodies against the body's own tissues. Depending on which antibodies and cells can be found in the tissue, different forms of this "autoimmune thyroiditis" are distinguished. The best known are Hashimoto's thyroiditis and Riedel's goiter. Rarely, drugs or other diseases such as AIDS are the cause.

How is the disease expressed?

The symptoms vary depending on the form:

  • In the acute form, it usually comes after an infection in the neck, nose or ear area to a renewed increase in fever with sweating and a rapidly increasing swelling of the thyroid gland, which is usually very painful. The pain can radiate into the ear and the jaw region, the swelling is often limited to an area, the skin over it is red. Those affected often feel very ill and have trouble swallowing.
  • The symptoms of the subacute form can range from missing symptoms to severe cases such as acute thyroiditis. Typical is the acute pressure pain, which can also radiate; the thyroid is only moderately enlarged. Sometimes, an overactive thyroid gland temporarily appears.
  • The chronic forms are usually associated with a painless enlargement of the thyroid gland. Especially at the beginning of the affected people usually have no complaints, which is why the disease is rarely detected in the early stages. Later, some types of airway and cervical pressure may be compromised. If the tissue is destroyed by the progressive inflammatory process, hypothyroidism results in corresponding symptoms. These include hypersensitivity, slowing the pulse, cool, dry skin and thin, scraggly hair, often sluggishness and depression.

How is the diagnosis made?

First, the doctor will raise the medical history. He will scan the thyroid gland and examine its size and condition with the ultrasound, possibly taking a tissue sample as well. The blood tests are important - depending on the suspected disease is sought after hormone changes, antibodies or signs of inflammation. Metabolic activity and thyroid function can be assessed by radioactively labeled substances during scintigraphy.

Which therapy is there?

Depending on the cause, antibiotics and anti-inflammatories and / or painkillers are prescribed. In acute inflammation, the patient should observe bed rest. Cold neck wraps help against the pain. In some cases cortisone is indicated, in others no treatment is necessary - the inflammation returns after a few weeks by itself. If there is a hypofunction, it will be compensated with thyroid medication.

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