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inflammation of the thyroid gland

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/08/06 21:34:32」(JST)

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Thyroiditis is the inflammation of the thyroid gland. The thyroid gland is located on the front of the neck below the laryngeal prominence, and makes hormones that control metabolism.

Classification

Thyroiditis is a group of disorders that all cause thyroidal inflammation. Forms of the disease are Hashimoto's thyroiditis, the most common cause of hypothyroidism in the US, postpartum thyroiditis, subacute thyroiditis, silent thyroiditis, drug-induced thyroiditis , radiation-induced thyroiditis, acute thyroiditis, and Riedel's thyroiditis.^[1]

Each different type of this disease has its own causes, clinical features, diagnoses, durations, resolutions, conditions and risks.

Signs and symptoms

There are many different signs and symptoms for thyroiditis, none of which are exclusively limited to this disease. Many of the signs imitate symptoms of other diseases, so thyroiditis can sometimes be difficult to diagnose. Common hypothyroid symptoms manifest when thyroid cell damage is slow and chronic, and may include fatigue, weight gain, feeling "fuzzy headed," depression, dry skin, and constipation. Other, rarer symptoms include swelling of the legs, vague aches and pains, decreased concentration and so on. When conditions become more severe, depending on the type of thyroiditis, one may start to see puffiness around the eyes, slowing of the heart rate, a drop in body temperature, or even incipient heart failure. On the other hand, if the thyroid cell damage is acute, the thyroid hormone within the gland leaks out into the bloodstream causing symptoms of thyrotoxicosis, which is similar to those of hyperthyroidism. These symptoms include weight loss, irritability, anxiety, insomnia, fast heart rate, and fatigue. Elevated levels of thyroid hormone in the bloodstream cause both conditions, but thyrotoxicosis is the term used with thyroiditis since the thyroid gland is not overactive, as in the case of hyperthyroidism.^[2]^[3]

Causes

Thyroiditis is generally caused by an attack on the thyroid, resulting in inflammation and damage to the thyroid cells. This disease is often considered a malfunction of the immune system. Antibodies that attack the thyroid are what causes most types of thyroiditis. It can also be caused by an infection, like a virus or bacteria, which works in the same way as antibodies to cause inflammation in the glands.^[4] Certain people make thyroid antibodies, and thyroiditis can be considered an autoimmune disease, because the body acts as if the thyroid gland is foreign tissue.^[5] Some drugs, such as interferon and amiodarone, can also cause thyroiditis because they have a tendency to damage thyroid cells.

Diagnosis/investigation

The most common and helpful way to diagnose thyroiditis is first for a physician to palpate the thyroid gland during a physical examination. Laboratory tests allow doctors to evaluate the patient for elevated erythrocyte sedimentation rates, elevated thyroglobulin levels, and depressed radioactive iodine intake (Mather, 2007). Blood tests also help to determine the kind of thyroiditis and to see how much thyroid stimulating hormone the pituitary gland is producing and what antibodies are present in the body. In some cases a biopsy may be needed to find out what is attacking the thyroid.

Epidemiology

Most types of thyroiditis are three to five times more likely to be found in women than in men. The average age of onset is between thirty and fifty years of age. This disease tends to be geographical and seasonal, and is most common in summer and fall.^[3]

Treatment

Treatments for this disease depend on the type of thyroiditis that is diagnosed. For the most common type, which is known as Hashimoto’s thyroiditis, the treatment is to immediately start hormone replacement. This prevents or corrects the hypothyroidism, and it also generally keeps the gland from getting bigger.^[6] However, Hashimoto's Thyroiditis can initially present with excessive thyroid hormone being released from the thyroid gland (hyperthyroid). In this case the patient may only need bed rest and non-steroidal anti-inflammatory medications; however, some need steroids to reduce inflammation and to control palpitations. Also, doctors may prescribe beta blockers to lower the heart rate and reduce tremors, until the initial hyperthyroid period has resolved.^[7]

Hashimoto’s Thyroiditis

Hashimoto's thyroiditis was first described by Japanese physician Hashimoto Hakaru working in Germany in 1912. Hashimoto’s thyroiditis is also known as chronic lymphocytic thyroiditis, and patients with this disease often complain about difficulty swallowing. This condition may be so mild at first that the disease goes unnoticed for years. The first symptom that shows signs of Hashimoto’s thyroiditis is a goitre on the front of the neck.^[6] Depending on the severity of the disease and how much it has progressed, doctors then decide what steps are taken for treatment.

References

American Thyroid Association, "What is Thyroiditis"

^ "Thyroiditis." www.thyroid.org. 2005. American Thyroid Association. 13 Mar. 2008. 15 Oct. 2010 <http://www.thyroid.org/patients/brochures/Thyroiditis.pdf>.
^ "Thyroiditis." www.thyroid.org. 2005. American Thyroid Association. 15 Oct. 2010 <http://www.thyroid.org/patients/brochures/Thyroiditis.pdf>.
^ ^a ^b Thyroiditis. FamilyDoctor.Org. 2011. American Academy of Family Physicians. <http://familydoctor.org/familydoctor/en/diseases-conditions/thyroiditis.html>.
^ De Groot, Leslie J., Nobuyuki Amino, and Akamizu Takashi. "Hashimoto's Thryoiditis." 30 Jan. 2007. Takashi Akamizu. 3 Mar. 2008 <www.thyroidmanager.org/Chapter8/chapter8.html>.
^ Mather, M.d., Ruchi. "Hashimoto's Thryoiditis." Medicine.Net. 8 Sept. 2007. 9 Mar. 2008 <http://www.medicinenet.com/hashimotos_thyroiditis/article.htm>.
^ ^a ^b "Hashimoto's Thryoiditis." ECureMe.Com. 2003. 15 Mar. 2008 <http://www.google.com/imgres?imgurl=http://www.ecureme.com>.
^ "Hashimotos Disease." Health Encyclopedia Diseases and ConditioNS. 2008. USA Today. 9 Mar. 2008 <http://www.healthscout.com/ency/68/277/main.html>.

UpToDate Contents

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1. 甲状腺の概要 overview of thyroiditis
2. 亜急性甲状腺炎 subacute thyroiditis
3. 無痛性甲状腺炎 painless thyroiditis
4. 橋本病（慢性自己免疫性甲状腺炎）の病因 pathogenesis of hashimotos thyroiditis chronic autoimmune thyroiditis
5. 小児および思春期における化膿性甲状腺炎 suppurative thyroiditis in children and adolescents

English Journal

Variation in the biochemical response to l-thyroxine therapy and relationship with peripheral thyroid hormone conversion efficiency.

Midgley JE1, Larisch R1, Dietrich JW2, Hoermann R3.
Endocrine connections.Endocr Connect.2015 Dec;4(4):196-205. doi: 10.1530/EC-150056.
Several influences modulate biochemical responses to a weight-adjusted levothyroxine (l-T4) replacement dose. We conducted a secondary analysis of the relationship of l-T4 dose to TSH and free T3 (FT3), using a prospective observational study examining the interacting equilibria between thyroid para
PMID 26335522

The zoonotic potential of Mycobacterium avium ssp. paratuberculosis: a systematic review and meta-analyses of the evidence.

Waddell LA1, Rajić A2, Stärk KD3, McEWEN SA1.
Epidemiology and infection.Epidemiol Infect.2015 Nov;143(15):3135-3157. Epub 2015 May 20.
This systematic review-meta-analysis appraises and summarizes all the available research (128 papers) on the zoonotic potential of Mycobacterium avium ssp. paratuberculosis. The latter has been debated for a century due to pathogenic and clinical similarities between Johne's disease in ruminants and
PMID 25989710

IL-4, IL-10 and high sensitivity-CRP as potential serum biomarkers of persistent/recurrent disease in papillary thyroid carcinoma with/without Hashimoto's thyroiditis.

Stanciu AE1, Serdarevic N, Hurduc AE, Stanciu MM.
Scandinavian journal of clinical and laboratory investigation.Scand J Clin Lab Invest.2015 Nov;75(7):539-48. doi: 10.3109/00365513.2015.1057895. Epub 2015 Jul 25.
OBJECTIVE: To investigate the potential role of interleukin 4 (IL-4), interleukin 10 (IL-10) and high-sensitivity C-reactive protein (hs-CRP) as serum biomarkers of persistent/recurrent disease in papillary thyroid carcinoma (PTC) with/without Hashimoto's thyroiditis (HT).METHODS: Eighty consecutive
PMID 26305420

Japanese Journal

橋本病甲状腺機能低下症と甲状腺抗体 : TPOAb,TGAb,ブロッキング抗体TSBAb

髙須信行
日本体質医学会雑誌 = The Japanese journal of constitutional medicine 77(1), 6-13, 2015-02
NAID 40020373456

臨床研究・症例報告急性化膿性甲状腺炎と甲状腺周囲軟部組織蜂窩織炎を伴った梨状窩瘻の1例

杉本健悟,濱中佳奈,平野有加 [他]
小児科臨床 68(2), 233-238, 2015-02
NAID 40020328332

Ultrasonographic appearance of focal Hashimoto's thyroiditis: A single institution experience

Wu Hongxun,Zhang Bingjie
Endocrine Journal 62(7), 655-663, 2015
… The purpose of this study was to determine the ultrasonographic (US) appearance of focal Hashimoto's thyroiditis (FHT). …
NAID 130005089853

Related Pictures

★リンクテーブル★

国試過去問	「105F015」
リンク元	「甲状腺炎」

「105F015」

Thyroiditis
	Above shows two parts of the thyroid that could potentially be affected if diagnosed with thyroiditis.
Classification and external resources
Specialty	Endocrinology
ICD-10	E06
ICD-9-CM	245
DiseasesDB	13095
eMedicine	ped/2248
MeSH	D013966

　　[★]

疾患と診療分野の組合せで適切でないのはどれか。

[正答]

※国試ナビ4※　［105F014］←［国試_105］→［105F016］

「甲状腺炎」

　　[★]

英: thyroiditis
関: 亜急性甲状腺炎

[1] "Thyroiditis." www.thyroid.org. 2005. American Thyroid Association. 13 Mar. 2008. 15 Oct. 2010 <http://www.thyroid.org/patients/brochures/Thyroiditis.pdf>.

[2] "Thyroiditis." www.thyroid.org. 2005. American Thyroid Association. 15 Oct. 2010 <http://www.thyroid.org/patients/brochures/Thyroiditis.pdf>.

[AmerAcad-3] Thyroiditis. FamilyDoctor.Org. 2011. American Academy of Family Physicians. <http://familydoctor.org/familydoctor/en/diseases-conditions/thyroiditis.html>.

[4] De Groot, Leslie J., Nobuyuki Amino, and Akamizu Takashi. "Hashimoto's Thryoiditis." 30 Jan. 2007. Takashi Akamizu. 3 Mar. 2008 <www.thyroidmanager.org/Chapter8/chapter8.html>.

[5] Mather, M.d., Ruchi. "Hashimoto's Thryoiditis." Medicine.Net. 8 Sept. 2007. 9 Mar. 2008 <http://www.medicinenet.com/hashimotos_thyroiditis/article.htm>.

[eCureMe-6] "Hashimoto's Thryoiditis." ECureMe.Com. 2003. 15 Mar. 2008 <http://www.google.com/imgres?imgurl=http://www.ecureme.com>.

[7] "Hashimotos Disease." Health Encyclopedia Diseases and ConditioNS. 2008. USA Today. 9 Mar. 2008 <http://www.healthscout.com/ency/68/277/main.html>.

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thyroiditis