Inflammation of the thyroid gland

introduction

Inflammation of the Thyroid tissue is known as thyroiditis. It is rare compared to other thyroid diseases. The most common causes are Autoimmune diseases. This depends on the immune system produced antibodies against the body's own cells.

bacteria, Viruses and external influences such as injuries and a Radiation treatment can also cause inflammation. What they have in common is that Inflammatory response as a result of a certain stimulus.

Symptoms

A renewed rise in fever after a bacterial infection can mark the onset of acute thyroid inflammation. There are signs of inflammation around the thyroid gland on the neck. The organ is painful to pressure. The skin is red, swollen and overheated. The pain can spread towards the ear.
Hoarseness, difficulty swallowing and swollen lymph nodes in the neck area are other symptoms.

Is there an enlarged thyroid gland (Goiter), pressure on neighboring structures can lead to different symptoms. These include shortness of breath, breathing difficulties, swallowing difficulties, a feeling of lumpiness and hoarseness due to pressure on the vagus nerve. Depending on the hormone production, there are additional symptoms of over- or under-function.

Hypothyroidism manifests itself through characteristic symptoms such as tiredness, freezing, weight gain, dry, cool skin, dry hair and slowed down actions.
The main symptoms of an overactive thyroid are a permanently increased pulse, moist, warm skin, increased blood pressure, restlessness with sleep disorders, trembling of the hands, sweating and weight loss.

In addition to an enlarged or swollen thyroid (Goiter) endocrine orbitopathy occurs in more than half of the cases. This is an autoimmune disease associated with Graves' disease.
As a result of inflammatory events in the area of ​​the eye socket, the eyeball can easily protrude from this.

Both autoimmune hyper- and hypothyroidism are not contagious. A thyrotoxic crisis in the context of hyperthyroidism can occur after increased iodine intake or in severe illnesses.
Certain drugs, as well as iodinated contrast media, are among the triggers. Confusion, a high pulse, restlessness, cardiac arrhythmias, vomiting and diarrhea occur within a very short time. Without treatment, it is a life-threatening condition.

Read about this too Thyroid pain

De Quervain

De Quervain's thyroiditis is a subacute inflammation of the thyroid gland.
As part of a De Quervain's thyroiditis general symptoms such as Exhaustion and fatigue on. When touching the thyroid gland painful be. Additional symptoms are fever, a headache, Muscle aches and clinical signs one Hyperthyroidism.
In comparison to acute thyroiditis, the Lymph nodes inconspicuous. Basically, with a subacute thyroid inflammation no risk of infection consists. The causal viral infection is usually healed at the beginning.

The subacute thyroid inflammation is named after the Swiss physician De Quervain. Their occurrence becomes frequent after viral infections of the respiratory tract observed. The disease proceeds in contrast to the acute form creeping. Most are Women between 30 and 50 years of age affected.

The healing of subacute thyroiditis occurs in the majority of cases spontaneous. Can support anti-inflammatory agents be taken. they seem pain reliever. Acetylsalicylic acid non-steroidal anti-inflammatory drug, is suitable for this therapy. Also Cortisone preparations are used in treatment.

Hashimoto

In adult women, the thyroid gland is undergone a reduction in size Hashimoto's thyroiditis most frequently. Again, it is an autoimmune disease. It is sometimes associated with other autoimmune diseases. These include the Addison's disease, the Turner Syndrome and the Rheumatoid arthritis.

In the course of this autoimmune disease, that becomes Thyroid tissue attacked and destroyed. Antibodies are often formed here too, but not in every patient suffering from Hashimoto's thyroiditis. That means the antibodies here Not as in Graves' disease for the disease responsible or proving are.

The symptoms are very different: while some patients almost symptom-free others suffer from a wide variety of symptoms, which often come first completely different diseases make you think.
In general, symptoms of one usually appear first Hyperthyroidism, then later the one Subfunction.
The cause of the disease cannot be treated, so the sick are with L-thyroxine treated to rebalance the hormonal balance, which is disturbed by the destruction of the tissue.

The exact course of Hashimoto's thyroiditis is difficult to predict. The destruction of the tissue leads to a Inability to produce hormones. For this reason, they must be replaced for life. Regular ultrasound and laboratory checks are important in the course.

causes

An acute inflammation of the thyroid is usually caused by bacteria triggered. These arrive via the blood- or Lymphatic system in the thyroid. A throat-, almond- or Sinus infection acts as a possible starting point for the infectious process.
Rare triggers include radioactive exposure, the Taking certain medications, one Injury to the organ and a Autoimmune reaction. Even after infections with fungi and with syphilis and tuberculosis inflammation can occur.

The thyroiditis after one pregnancy shows a subacute course. Their cause is based on autoimmune processes.
Common cause of a Goiter is a chronic one Iodine deficiency. A lack of iodine in the thyroid leads to increased production different growth factors. You can ... a Swelling of the organ cause.

At the Graves disease is a Autoimmune disease with increased hormone production. It manifests itself through a hyperthyroidism and a inflammatory tissue growth behind the eyeball. The cause of the hyperfunction are autoantibodies that the thyroid gland to increased production of Hormones stimulate.

Hypothyroidism includes that underactive thyroid up to total failure their function.

diagnosis

A typical symptom already gives first indications of the possible cause.
The thyroid can be felt with the fingertips. It is located a little below the larynx and lies in front of the windpipe.
An increase in size is possible as part of an inflammatory reaction. A goiter may not be visible at first glance and only become noticeable when you touch it. If the process has been going on for some time, the goiter can be clearly visible on the neck.

In the case of acute thyroid inflammation, increased inflammation values ​​are shown in the laboratory. There is an increased sedimentation rate (BSG) and an increased concentration of white blood cells (Leukocytosis) in front.
In the context of subacute thyroiditis, the ESR is also greatly accelerated, while the white blood cells show only a slight increase. The concentration of thyroid antibodies can increase.

The determination of the basal TSH value in the laboratory helps to make a statement about the thyroid function. The peripheral thyroid hormones T3 and T4 are usually only determined when the TSH levels have changed. If the TSH as well as T3 and T4 are in the normal range, the metabolic situation is in equilibrium, that is euthyroid. This constellation is the most common.
If the TSH is elevated, it is a latent (T3 / T4 in the normal range) or manifest (T3 / T4 decreased) Hypothyroidism. One speaks of a subfunction.
If the TSH is low, there is latent or manifest hyperthyroidism, i.e. overfunction, according to the values ​​of T3 and T4.

The determination of thyroid antibodies and the performance of a thyroid scintigraphy are used to differentiate Graves' disease, the autonomic thyroid adenoma and the diffuse independence of a thyroid area.
To confirm Graves' disease, in addition to the clinical picture, certain antibodies (TRAK) are available.

In addition, a tissue sample (biopsy) of the thyroid gland can be useful in establishing the diagnosis. Typically, several thousand cells are obtained by fine needle aspiration and examined in the laboratory.

Learn more at: Thyroid biopsy

The hypothyroid goiter can follow a Thyroid surgery or one Radioiod- or. thyrostatic therapy be. in the Ultrasonic one recognizes one scaled down, hypoechoic Thyroid.

If this is not the case, one determines to be excluded Hashimoto's thyroiditis Thyroid peroxidase and thyroglobulin antibodies. Sonography is just as important as the examination of the thyroid-specific laboratory values.
An ultrasound examination is used to determine the Thyroid volume and looking for Thyroid nodules. In the case of subacute inflammation, it serves to rule out other diseases.

As a result of acute inflammation can bacterial abscesses that can be visualized in the ultrasound. When newly occurring diffuse knot, should urgently a further clarification respectively.

If there are any lumps, it makes sense to do a thyroid scintigraphy. To rule out malignant growth or to precisely clarify a hyperthyroid metabolic situation, the Activity of individual areas to verify. Before the examination, a vein low level radioactive iodine injected. Depending on the activity of the tissue, the radionuclide is increased or decreased in some places. One speaks accordingly of hot knot (increased activity) and cold knots (decreased intake)
If thyroid scintigraphy shows there is a cold nodule with a diameter of more than one centimeter before, a biopsy should be performed to rule out thyroid cancer.

The Fine needle puncture serves for the exact clarification of the removed tissue. It is also used to clarify de Quervain's thyroiditis. Typically, fine nodules, so-called granulomas, form, which are examined.

therapy

The therapy of acute thyroiditis should in any case bed rest include. Home remedies like cooling neck wrap and adequate hydration also play an important role. In the case of a bacterial cause, appropriate Antibiotics are used. They are usually given in tablet form. Cortisone preparations provide rapid symptom relief.

If it is a hypothyroid goiter, the lifelong therapy is included
L-thyroxine. Since the thyroid produces insufficient hormones, one leads T4 (Levothyroxine) in tablet form. A stable TSH value in the normal range should be aimed for.

Graves' disease can be eliminated in half of the cases within a year with the help of a thyrostatic therapy adequately treated. If this is not the case, definitive therapy follows. This can take the form of a Radioiodine therapy happen. Another possibility is to initiate a Thyroid surgery.

Treating a functional autonomy (Self-reliance) of the thyroid gland with a hyperthyroid goiter is initially carried out with anti-thyroid drugs. They inhibit hormone production and are given until a normal metabolism is reached. Then part of the thyroid gland is removed if the lump is large. Radioiodine therapy is performed for smaller nodules. This form of therapy is mainly used in older patients.

Euthyroid goiter without functional autonomy are usually with the help of Iodide treated. Additionally or alternatively, a thyroid hormone can be administered. Younger patients in particular respond well to iodine administration. The aim of therapy is Decrease in thyroid volume. Your control should be regular means Ultrasonic respectively.

The Thyroid surgery promises one immediate success. However, it harbors some Risks. These include Bleeding, the Paralysis of the vagus nerve and a Underactive parathyroid gland. Such a subtotal thyroid resection is considered when drug therapy fails. Even with complications excessive thyroid growth and at A malignant lump is suspected surgery is indicated.

forecast

The prognosis of acute thyroid inflammation is this Well. With timely Antibiotic therapy sounds the disease without consequences within less days from. If the thyroid tissue is severely damaged, however, a Subfunction occur.
The subacute form should help with anti-inflammatory agents be treated. This is how thyroiditis heals too without permanent damage within less weeks to months from. In individual cases, an underfunction develops, so that once a year control the thyroid levels should be done.