Thyroiditis

Diseases of the thyroid gland, various in etiology and pathogenesis. Inflammation of a diffusely enlarged thyroid gland is called strumitis.

Acute thyroiditis - purulent or non-purulent. It can be diffuse and focal. Acute purulent thyroiditis develops against the background of acute or chronic infection (tonsillitis, pneumonia, etc.).

Symptoms: pain in the anterior surface of the neck, radiating to the back of the head, lower and upper jaw, aggravated by moving the head and swallowing. Enlarged cervical lymph nodes. Fever, chills.

On palpation, there is a painful enlargement of part or the entire lobe of the thyroid gland; when an abscess has formed, there is fluctuation. High leukocytosis, shift of the leukocyte formula to the left, increased ESR. When scanning the thyroid gland, a “cold area” is determined that does not absorb radionuclide and corresponds to an inflammatory focus.

Acute non-purulent thyroiditis can develop after injury, hemorrhage into the gland, or radiation therapy. It proceeds according to the type of aseptic inflammation. Symptoms are less pronounced than with acute purulent inflammation of the thyroid gland.

Subacute thyroiditis (de Quervain's thyroiditis). Women aged 30-50 years are more likely to get sick. Develops after viral infections.

Symptoms: pain in the neck, radiating to the occipital region, lower jaw, ears, temporal region. Headache, weakness, weakness. Increased body temperature.

Increased ESR, leukocytosis. May occur without changes in the blood. At the onset of the disease (hyperthyroid, acute stage), symptoms of thyrotoxicosis are possible: tachycardia, sweating, weight loss, hand tremors.

In the blood - increased levels of thyroid hormones, during scanning - a decrease in the uptake of isotopes by the thyroid gland. Over a long period of time, symptoms of hypothyroidism (hypothyroid stage), drowsiness, lethargy, lethargy, chilliness, swelling of the face, dry skin, bradycardia, and constipation may develop. The thyroid gland is enlarged (often only its right lobe), dense in consistency, not fused with the surrounding tissues, and painful on palpation.

In the blood there is a low content of thyroxine and triiodothyronine and a high content of thyroid-stimulating hormone. During the recovery stage, pain in the thyroid gland disappears, ESR, levels of thyroid hormones and thyrotropin in the blood normalize. The disease is prone to recurrence, especially with repeated viral infections and hypothermia.

Chronic fibrous thyroiditis (Riedel's goiter) is a disease of unknown etiology.

Symptoms: diffuse, less often focal enlargement of the thyroid gland. The gland is very dense, immobile, does not move when swallowing, and is fused to the surrounding tissues.

The progression and spread of the process to the entire gland is accompanied by the development of hypothyroidism. With large gland sizes, symptoms of compression of the neck organs are observed: hoarseness, difficulty swallowing, breathing. An important diagnostic method is puncture biopsy.

Autoimmune chronic thyroiditis (Hashimoto's thyroiditis) is a disease based on autoimmune damage to the thyroid gland, the formation of antibodies to various components of the thyroid gland - thyroglobulin, microsomal fraction, thyrotropin receptors - with the formation of an antigen-antibody complex, the development of destructive changes and lymphoid infiltration of the thyroid glands.

Symptoms: diffuse, sometimes uneven enlargement of the thyroid gland, when palpated the gland has a dense elastic consistency, mobile. When the gland is large, symptoms of compression of the neck organs appear.

As the disease develops, destructive changes lead to dysfunction of the gland - initially to the phenomena of hyperthyroidism due to the entry into the blood of a large amount of previously synthesized hormones, later (or bypassing the hyperthyroid phase) - to hypothyroidism. Ti Contents