亜急性甲状腺炎
WordNet
- watch over; "I am overlooking her work"
- a high place affording a good view
- look past, fail to notice
- less than acute; relating to a disease present in a person with no symptoms of it
- inflammation of the thyroid gland
PrepTutorEJDIC
- …‘を'『見落とす』,見逃す / ‥‘を'『大目に見る』,‘に'目をつぶる / 〈人が〉…‘を'『見おろす』 / 〈場所が〉…‘を'『見渡せる』,見おろす
Wikipedia preview
出典(authority):フリー百科事典『ウィキペディア(Wikipedia)』「2015/08/27 08:29:13」(JST)
[Wiki en表示]
Subacute thyroiditis |
Micrograph showing a granuloma in subacute thyroiditis. H&E stain.
|
Classification and external resources |
Specialty |
endocrinology |
ICD-10 |
E06.1 |
ICD-9-CM |
245.1 |
MedlinePlus |
000375 |
eMedicine |
article/125648 |
MeSH |
D013968 |
Subacute thyroiditis is a form of thyroiditis that can be a cause of both thyrotoxicosis and hypothyroidism.[1] It is uncommon and can affect individuals of both sexes and all ages. The most common form, subacute granulomatous, or de Quervain's, thyroiditis manifests as a sudden and painful enlargement of the thyroid gland accompanied with fever, malaise and muscle aches. Indirect evidence has implicated viral infection in the aetiology of subacute thyroiditis. This evidence is limited to preceding upper respiratory tract infection, elevated viral antibody levels, and both seasonal and geographical clustering of cases. There may be a genetic predisposition. [2]
Nishihara and coworkers studied the clinical features of subacute thyroiditis in 852 mostly 40-50 year old women in Japan. They noted seasonal clusters (summer to early autumn) and most subjects presented with neck pain. Fever and symptoms of thyrotoxicosis was present in two thirds of subjects. Upper respiratory tract infections in the month preceding presentation were reported in only 1 in 5 subjects. Recurrent episodes following resolution of the initial episode were rare, occurring in just 1.6% of cases. Laboratory markers for thyroid inflammation and dysfunction typically peaked within one week of onset of illness.
Types include:
- De Quervain's thyroiditis
- Subacute lymphocytic thyroiditis
- Postpartum thyroiditis
- Palpation thyroiditis
References
- ^ "Subacute Thyroiditis: Overview - eMedicine Endocrinology".
- ^ Nishihara, E.; Ohye, H.; Amino, N.; Takata, K.; Arishima, T.; Kudo, T.; Ito, M.; Kubota, S.; Fukata, S.; Miyauchi, A. (2008). "Clinical characteristics of 852 patients with subacute thyroiditis before treatment.". Internal Medicine 47 (8): 725–729. doi:10.2169/internalmedicine.47.0740. PMID 18421188.
UpToDate Contents
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English Journal
- Time-lag between symptom onset and laboratory findings in patients with subacute thyroiditis.
- Tachibana T1, Orita Y2, Ogawara Y3, Matsuyama Y3, Abe I3, Nakada M4, Sato Y5, Nishizaki K2.
- Auris, nasus, larynx.Auris Nasus Larynx.2014 Aug;41(4):369-72. doi: 10.1016/j.anl.2013.11.003. Epub 2013 Dec 22.
- OBJECTIVE: The objective of this study was to delineate the frequency of delayed diagnosis in cases of subacute thyroiditis (SAT) and intervals between onset of clinical symptoms and appearance of abnormal laboratory findings.METHODS: We reviewed the medical records of 27 patients (7 men and 20 wome
- PMID 24368199
- A novel treatment for subacute thyroiditis: administration of a mixture of lidocaine and dexamethasone using an insulin pen.
- Ma SG, Bai F, Cheng L.
- Mayo Clinic proceedings.Mayo Clin Proc.2014 Jun;89(6):861-2. doi: 10.1016/j.mayocp.2014.03.013.
- PMID 24943704
- Ultrasound findings of subacute thyroiditis: a single institution retrospective review.
- Cappelli C1, Pirola I, Gandossi E, Formenti AM, Agosti B, Castellano M.
- Acta radiologica (Stockholm, Sweden : 1987).Acta Radiol.2014 May;55(4):429-33. doi: 10.1177/0284185113498721. Epub 2013 Aug 22.
- BACKGROUND: High resolution ultrasonography features have also been described as having a useful supporting role in the diagnosis of subacute granulomatous thyroiditis (ST), and images are generally characterized by heterogeneous hypoechoic areas of the affected tissue with lack of flow on color Dop
- PMID 23969266
Japanese Journal
- 無痛性甲状腺炎,亜急性甲状腺炎 (特集 甲状腺疾患 : 診断と治療)
- 渡嘉敷 邦彦,塚原 清彰,山中 弘明 [他],本橋 玲,遠藤 稔,岡吉 洋平,髙瀬 聡一郎,中村 一博
- 耳鼻咽喉科臨床 106(12), 1127-1131, 2013
- … Subacute thyroiditis is a nonsuppurative inflammatory disease whose treatment differs from that of acute suppurative thyroiditis. … We report herein on a case diagnosed as subacute thyroiditis in which a deep cervical abscess developed as a result of overdosing with a steroid hormone agent. …
- NAID 130003386104
- 無痛性甲状腺炎,亜急性甲状腺炎 (特集 甲状腺疾患 : 診断・治療の最新動向) -- (主要疾患の病態・診断・治療)
Related Links
- There is some controversy concerning the nomenclature used to categorize the different forms of subacute thyroiditis. However, most thyroidologists use the term subacute thyroiditis to apply specifically to subacute granulomatous ...
- Subacute Thyroiditis. Subacute thyroiditis is a self-limited thyroid condition associated with a triphasic clinical course of hyperthyroidism, hypothyroidism, and return to normal thyroid function. ... Destruction of follicular ...
Related Pictures
★リンクテーブル★
[★]
- 英
- subacute thyroiditis
- 同
- ドゥ・ケルヴァン甲状腺炎
- 関
- 甲状腺
概念
- 有痛性の甲状腺腫脹がみられ、ときに発熱が認められる甲状腺炎である。病気によって甲状腺中毒症や甲状腺機能低下症を呈する。全身倦怠感や感染による上気道炎が、数週間くらい甲状腺にまつわる特徴(thyroid-related features)に先行する。(HIM.2238)
- 全身性ウイルス性感染(mumps、coxsackie, adenoviruses, measles, Influenza, echoviruses)に伴うが、患者からウイルスを同定する試みはしばしば不成功に終わり、病原体同定することは本疾患の管理に影響を及ぼさない。(HIM.2238)
- 症状は咽頭炎に似ており、しばしば見落とされる。(HIM.2238)
疫学
- 30-50歳 (HIM.2238)
- 男女=1:3 (HIM.2238)
病期~
- 1) destructive phase:濾胞破壊によるhyperthyroid。甲状腺中毒症(T3,T4高値。TSH低値)。123I uptakeは低値か検出下限以下。
- 2) phase of hypothyroidism:数週間の経過で甲状腺機能低下症となる。unbound T4低値、軽度TSH高値。123I uptakeは正常化やや高値
- 3) recovery phase:正常化
病理
- 斑状に炎症細胞の浸潤が認められ、甲状腺濾胞のdisruptionを伴う。甲状腺濾胞には多核巨細胞が認められるものがある。濾胞の変化は線維化を伴う肉芽腫に進展する。発症から数ヶ月で甲状腺は通常正常に回復する。
- マクロ:非対称性腫大。
- 組織像:多核巨細胞、リンパ球、形質細胞、組織球、急性炎症を示す箇所、線維化巣、肉芽腫形成。
症状
- 局所の圧痛と自然痛、発熱、全身倦怠感、数カ月で回復。
身体所見
検査
- 甲状腺機能:病期による。
- 超音波検査:炎症部位・腫瘤部に一致して低エコーとなる。
グレーブス病、亜急性甲状腺炎、無痛性甲状腺炎の比較
- YN.D-40改変
参考
- 1. [charged] 亜急性甲状腺炎 - uptodate [1]
国試
[★]
- 上から見る、見下ろす、見晴らす、見渡す。~を見下ろすような高いところにある
- 監督/監視する。世話する。検閲する。者癌で見つめて魔法にかける
- ~に目を通す、ざっと見る。見落とす、見過ごす
- The diagnosis of subacute thyroiditis is often overlooked because the symptoms can mimic pharyngitis.(HIM.2238)
- overlookすること、見落とし。見晴らしの良いところ、見晴台、高台。見晴らし、眺め。
[★]
- 英
- de Quervain thyroiditis
- 同
- 亜急性甲状腺炎 subacute thyroiditis、偽結核性巨細胞性非化膿性甲状腺炎 pseudotuberculous giant cell and nonsuppurative thyroiditis、巨細胞性肉芽腫性甲状腺炎 giant cell granulomatous thyroiditis