Acute thyroiditis is an acute inflammation of the thyroid gland . It is rare in children [1] . Distinguish diffuse or focal purulent and non-purulent acute thyroiditis [2] .
| Acute thyroiditis | |
|---|---|
| ICD-10 | E 06.0 |
| ICD-10-KM | |
| ICD-9 | 245.0 |
| Diseasesdb | 34307 |
| Mesh | D013969 |
Content
- 1 Acute suppurative thyroiditis
- 1.1 Etiology
- 1.2 Pathogenesis
- 1.3 Epidemiology
- 1.4 Clinical picture
- 1.5 Diagnostics
- 1.6 Differential Diagnostics
- 1.7 Treatment
- 1.8 Forecast
- 1.9 Prevention
- 2 Non-purulent acute thyroiditis
- 2.1 Etiology and pathogenesis
- 2.2 Clinical picture
- 2.3 Treatment
- 2.4 Forecast
- 2.5 Prevention
- 3 notes
- 4 References
Acute Purulent Thyroiditis
Etiology
The etiological factor of acute thyroiditis can be any infectious disease. After pneumonia , acute tonsillitis , sinusitis, or otitis media, bacteria can penetrate into the thyroid gland by hematogenous (with blood flow) or lymphogenous (along the lymphatic drainage pathways) by causing the development of an acute inflammatory process [2] .
Pathogenesis
Part of the lobe or the entire lobe of the thyroid gland is involved in the inflammatory process. The sequential development of all stages of inflammation is characteristic: alteration , exudation and proliferation [2] .
Epidemiology
The use of antibiotics for the treatment of coccal infections has made this form of thyroiditis very rare [2] .
Clinical picture
Varies depending on the prevalence of local or general symptoms. The onset of the disease is acute - fever, chills, headache, malaise. The leading and constant symptom of acute thyroiditis in children is pain of varying intensity in the thyroid gland and an enlarged gland in size [1] .
Diagnostics
It is based on the history of the presence of the primary focus of infection, a rapid increase in body temperature and pain, the positive effect of antibiotic therapy, and the absence of signs of impaired thyroid function. In a clinical blood test, leukocytosis with a shift of the leukocyte formula to the left, a moderate acceleration of ESR to 20-25 mm / h, is detected. An ultrasound scan of the thyroid tissue is uninformative, but it can detect an abscess - a site with liquid contents and an increase in regional lymph nodes. Additional data may be provided by a fine needle aspiration biopsy, after which an antibiotic is injected directly into the thyroid tissue using the same needle [2] .
Differential Diagnostics
Treatment
Forecast
Favorable - the disease does not lead to impaired thyroid function, disability is fully restored at the end of the acute phase of inflammation [2] .
Prevention
Timely antibacterial therapy of primary foci of infection [2] .
Non-purulent acute thyroiditis
Etiology and pathogenesis
This group of diseases arises due to trauma and hemorrhage in the tissue of the thyroid gland or after radiation therapy. Diseases proceed as an aseptic inflammation [2] .
Clinical picture
Patients complain of pain, a sense of pressure in the thyroid gland, sometimes mild thyrotoxicosis is detected; tachycardia , emotional lability , sweating can be observed. Against the background of treatment of the disease, recovery occurs within 3-4 weeks [2] .
Treatment
Symptomatic: analgesics, beta-blockers [2] .
Forecast
Favorable - disability is fully restored, with the exception of cases of development of persistent hypothyroidism as a result of radiation therapy [2] .
Prevention
The recently used technique of treatment with fractional doses of radioactive iodine ( 131 I) has reduced the number of cases of radiation thyroiditis (they were previously observed in 5% of cases in patients 2-3 weeks after taking the radiopharmaceutical as a result of destruction of the follicular epithelium [2] .
Notes
- β 1 2 Handbook of a pediatrician-endocrinologist / Ed. M.A. Zhukovsky. - 1st ed. - M .: Medicine, 1992 .-- S. 236. - 304 p. - 20,000 copies. - ISBN 5-225-02616-8 .
- β 1 2 3 4 5 6 7 8 9 10 11 12 Clinical endocrinology. Leadership / Ed. N.T. Starkova. - 3rd ed., Revised. and add. - SPb. : Peter, 2002 .-- S. 165-167. - 576 p. - ("Doctor's Companion"). - 4000 copies. - ISBN 5-272-00314-4 .