De Quervain's thyroiditis from other diseases: Difference between revisions

	De Quervain's thyroiditis Microchapters
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Differentiating De Quervain's thyroiditis from other Diseases
Epidemiology and Demographics
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Diagnosis
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Revision as of 20:36, 27 September 2017

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Furqan M M. M.B.B.S [2]

Overview

De Quervain's thyroiditis must be differentiated from other causes of thyroiditis, such as Hashimoto's thyroiditis, Riedel's thyroiditis, and suppurative thyroiditis.

Differentiating De Quervain's thyroiditis from other diseases

De Quervain's thyroiditis must be differentiated from other causes of thyroiditis, such as Hashimoto's thyroiditis, Riedel's thyroiditis, and suppurative thyroiditis.^[1]

Conditions	Causes	Age at onset	Pathological findings	Diagnostic approach
Painful subacute (De Quervain's) thyroiditis	Unknown	20-60	Giant cells Granulomas	Increased TSH (hypothyroidism) and/or Decreased TSH (Thyrotoxicosis) TPO antibodies absent or very low titer I-123 uptake decreased
Hashimoto's thyroiditis	Autoimmune	All ages, peak at 30-50	Lymphocytic infiltration Germinal centers Fibrosis (in some variants)	Increased TSH (hypothyroidism) TPO antibodies present in high titer I-123 uptake usually decreased
Silent thyroiditis	Autoimmune	All ages, peak at 30-40	Lymphocytic infiltration Lymphoid follicles	Increased TSH (hypothyroidism) and/or Decreased TSH (transient hypothyroidism) TPO antibodies present in high titer I-123 uptake usually decreased
Postpartum thyroiditis	Autoimmune	Childbearing age	Lymphocytic infiltration	Increased TSH (hypothyroidism) and/or Decreased TSH (transient hypothyroidism) TPO antibodies present in high titer I-123 uptake usually decreased
Riedel's thyroiditis	Unknown	30-60	Dense fibrosis	Normal TSH (euthyroidism) TPO antibodies usually present I-123 uptake decreased or normal
Suppurative thyroiditis	Infection	Children, 20-40	Abscess formation	Normal TSH (euthyroidism) TPO antibodies absent I-123 uptake normal

De Quervain's thyroiditis must be differentiated from other causes of hypothyroidism on the basis of history and symptoms and laboratory findings:^[2]^[3]^[1]^[4]^[5]^[6]

Disease		History and symptoms		Laboratory findings							Additional findings
Disease		Fever	Pain	TSH	Free T4	T3	T3RU†	Thyroglobin	TRH	TPOAb^	Additional findings
Transient hypothyroidism	Subacute (de Quervain's) thyroiditis	+/-	+/-	↑/↓	↓/↑	Normal	↓	↑	Normal	Low/absent	May present primarily with hyperthyroidism
	Postpartum thyroiditis	+/-	+/-	↑/↓	↓/↑	Normal	↓	↑	Normal/↑	Present (high titer)	May present primarily with hyperthyroidism
	Silent thyroiditis	-	-	↑/↓	↓/↑	Normal	↓	↑	Normal	Present (high titer)	May present primarily with hyperthyroidism
Primary hypothyroidism	Autoimmune (Hashimoto's thyroiditis)	-	-	↑*	↓	Normal/↓	Normal/↓	Normal/↑	Normal	Present (high titer)	May be accompanied by other autoimmune diseases
	Riedel's thyroiditis	-	-	Normal/↑	Normal/↓	Normal/↓	Normal/↓	Normal	Normal	Usually present	Riedel's thyroiditis usually presents with hard and fixed thyroid mass.
	Infectious thyroiditis	+	+	Normal	Normal	Normal	Normal	Normal	Normal	Absent	Infectious thyroiditis associated with neck pain
Others	Drug-induced	-	-	↑/↓	↓/↑	Normal	↓	Normal/↑	Normal	Absent**	History of hyperthyroidism History of trauma History of drug use, surgery, or radiation
	Radiation-induced
	Trauma induced
	Radioiodine induced
	Thyroidectomy
	Subclinical hypothyroidism	-	-	↑	Normal	Normal	Normal	Normal	Normal	Normal/↑	Asymptomatic

(†)T3RU; Triiodothyronine Resin uptake. (^)TPOAb; Thyroid peroxidase antibodies. (*)TSH may be decreased transiently in the thyrotoxicosis. (**)TPOAb may be present in drug-induced hypo/hyperthyroidism such as Interferon-alpha, interleukin-2, and lithium.

References

↑ ^1.0 ^1.1 "Thyroiditis — NEJM".
↑ Bindra A, Braunstein GD (2006). "Thyroiditis". Am Fam Physician. 73 (10): 1769–76. PMID 16734054.
↑ McDermott MT (2009). "In the clinic. Hypothyroidism". Ann. Intern. Med. 151 (11): ITC61. doi:10.7326/0003-4819-151-11-200912010-01006. PMID 19949140.
↑ Aoki Y, Belin RM, Clickner R, Jeffries R, Phillips L, Mahaffey KR (2007). "Serum TSH and total T4 in the United States population and their association with participant characteristics: National Health and Nutrition Examination Survey (NHANES 1999-2002)". Thyroid. 17 (12): 1211–23. doi:10.1089/thy.2006.0235. PMID 18177256.
↑ Lania A, Persani L, Beck-Peccoz P (2008). "Central hypothyroidism". Pituitary. 11 (2): 181–6. doi:10.1007/s11102-008-0122-6. PMID 18415684.
↑ De Groot LJ, Chrousos G, Dungan K, Feingold KR, Grossman A, Hershman JM, Koch C, Korbonits M, McLachlan R, New M, Purnell J, Rebar R, Singer F, Vinik A, Stockigt J. "Clinical Strategies in the Testing of Thyroid Function". PMID 25905413.

[urlThyroiditis_—_NEJM-1] 1.0 ^1.1 "Thyroiditis — NEJM".

[pmid16734054-2] Bindra A, Braunstein GD (2006). "Thyroiditis". Am Fam Physician. 73 (10): 1769–76. PMID 16734054.

[pmid19949140-3] McDermott MT (2009). "In the clinic. Hypothyroidism". Ann. Intern. Med. 151 (11): ITC61. doi:10.7326/0003-4819-151-11-200912010-01006. PMID 19949140.

[pmid18177256-4] Aoki Y, Belin RM, Clickner R, Jeffries R, Phillips L, Mahaffey KR (2007). "Serum TSH and total T4 in the United States population and their association with participant characteristics: National Health and Nutrition Examination Survey (NHANES 1999-2002)". Thyroid. 17 (12): 1211–23. doi:10.1089/thy.2006.0235. PMID 18177256.

[pmid18415684-5] Lania A, Persani L, Beck-Peccoz P (2008). "Central hypothyroidism". Pituitary. 11 (2): 181–6. doi:10.1007/s11102-008-0122-6. PMID 18415684.

[pmid25905413-6] De Groot LJ, Chrousos G, Dungan K, Feingold KR, Grossman A, Hershman JM, Koch C, Korbonits M, McLachlan R, New M, Purnell J, Rebar R, Singer F, Vinik A, Stockigt J. "Clinical Strategies in the Testing of Thyroid Function". PMID 25905413.

[1]

[2]

[3]

[4]

[5]

[6]

@@ Line 5: / Line 5: @@
 [[De Quervain's thyroiditis]] must be differentiated from other causes of [[thyroiditis]], such as [[Hashimoto's thyroiditis]], [[Riedel's thyroiditis]], and suppurative thyroiditis.
 ==Differentiating De Quervain's thyroiditis from other diseases==
-*[[De Quervain's thyroiditis]] must be differentiated from other causes of [[thyroiditis]], such as [[Hashimoto's thyroiditis]], [[Riedel's thyroiditis]], and suppurative thyroiditis.<ref name="urlThyroiditis — NEJM">{{cite web |url=http://www.nejm.org/doi/full/10.1056/NEJMra021194 |title=Thyroiditis — NEJM |format= |work= |accessdate=}}</ref><br>
+*[[De Quervain's thyroiditis]] must be differentiated from other causes of [[thyroiditis]], such as [[Hashimoto's thyroiditis]], [[Riedel's thyroiditis]], and suppurative thyroiditis.<ref name="urlThyroiditis — NEJM">{{cite web |url=http://www.nejm.org/doi/full/10.1056/NEJMra021194 |title=Thyroiditis — NEJM |format= |work= |accessdate=}}</ref>
 {| align="center"
 |-
 |}
-{| style="border: 0px; font-size: 90%; margin: 6px;" align="center"
+{| style="border: 0px; font-size: 90%; margin: 3px;" align="center"
 ! style="background:#4479BA; color: #FFFFFF;" | Conditions
 ! style="background:#4479BA; color: #FFFFFF;" |Causes
@@ Line 15: / Line 15: @@
 ! style="background:#4479BA; color: #FFFFFF;" |Pathological findings
 ! style="background:#4479BA; color: #FFFFFF;" |Diagnostic approach
 |-
 | align="center" style="background:#DCDCDC;" |[[De Quervain's thyroiditis|Painful subacute (De Quervain's) thyroiditis]]
@@ Line 42: / Line 41: @@
 | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
 *[[Thyroid function tests|Increased TSH]] (hypothyroidism)
+*[[Thyroid peroxidase|TPO antibodies]] present in high titer
+*[[I-123 thyroid imaging|I-123]] uptake usually decreased
+|-
+| align="center" style="background:#DCDCDC;" |[[Silent thyroiditis]]
+| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
+*Autoimmune
+| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
+*All ages, peak at 30-40
+| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
+*Lymphocytic infiltration
+*Lymphoid follicles
+| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
+*[[Thyroid function tests|Increased TSH]] (hypothyroidism) and/or
+* [[Thyroid function tests|Decreased TSH]] (transient hypothyroidism)
+*[[Thyroid peroxidase|TPO antibodies]] present in high titer
+*[[I-123 thyroid imaging|I-123]] uptake usually decreased
+|-
+| align="center" style="background:#DCDCDC;" |[[Postpartum thyroiditis]]
+| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
+*Autoimmune
+| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
+*Childbearing age
+| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
+*Lymphocytic infiltration
+| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
+*[[Thyroid function tests|Increased TSH]] (hypothyroidism) and/or
+* [[Thyroid function tests|Decreased TSH]] (transient hypothyroidism)
 *[[Thyroid peroxidase|TPO antibodies]] present in high titer
 *[[I-123 thyroid imaging|I-123]] uptake usually decreased
@@ Line 83: / Line 109: @@
 ! align="center" style="background: #4479BA; color: #FFFFFF; " |<small> Free T4
 ! align="center" style="background: #4479BA; color: #FFFFFF; " |<small> T3
-! align="center" style="background: #4479BA; color: #FFFFFF; " |<small> T3RU''†''
+! align="center" style="background: #4479BA; color: #FFFFFF; " |<small> T3RU<small>†
 ! align="center" style="background: #4479BA; color: #FFFFFF; " |<small> Thyroglobin
 ! align="center" style="background: #4479BA; color: #FFFFFF; " |<small> TRH
 ! align="center" style="background: #4479BA; color: #FFFFFF; " |<small> TPOAb^
 |-
-|-
+| rowspan="3" style="background:#DCDCDC;" |[[Hypothyroidism|Transient hypothyroidism]]
-| rowspan="2" style="background:#DCDCDC;" |[[Hypothyroidism|Transient hypothyroidism]]
 | align="center" style="background:#DCDCDC;" |[[De Quervain's thyroiditis|Subacute (de Quervain's) thyroiditis]]
 | align="center" style="padding: 5px 5px; background: #F5F5F5;" | +/-
 | align="center" style="padding: 5px 5px; background: #F5F5F5;" | +/-
-| align="center" style="padding: 5px 5px; background: #F5F5F5;" |'''↓/'''↑
+| align="center" style="padding: 5px 5px; background: #F5F5F5;" |'''↑/'''↓
-| align="center" style="padding: 5px 5px; background: #F5F5F5;" |↑/'''↓'''
+| align="center" style="padding: 5px 5px; background: #F5F5F5;" |↓/'''↑'''
-| align="center" style="padding: 5px 5px; background: #F5F5F5;" |N
+| align="center" style="padding: 5px 5px; background: #F5F5F5;" |Normal
 | align="center" style="padding: 5px 5px; background: #F5F5F5;" |↓
 | align="center" style="padding: 5px 5px; background: #F5F5F5;" |↑
-| align="center" style="padding: 5px 5px; background: #F5F5F5;" |N
+| align="center" style="padding: 5px 5px; background: #F5F5F5;" |Normal
-| align="center" style="padding: 5px 5px; background: #F5F5F5;" |Absent
+| align="center" style="padding: 5px 5px; background: #F5F5F5;" |Low/absent
 | align="left" style="padding: 5px 5px; background: #F5F5F5;" |
-* May present primarily with [[hyperthyroidism]]
+*May present primarily with [[hyperthyroidism]]
 |-
-| align="center" style="background:#DCDCDC;" |Post-partum thyroiditis
+| align="center" style="background:#DCDCDC;" |[[Postpartum thyroiditis]]
 | align="center" style="padding: 5px 5px; background: #F5F5F5;" | +/-
 | align="center" style="padding: 5px 5px; background: #F5F5F5;" | +/-
 | align="center" style="padding: 5px 5px; background: #F5F5F5;" |'''↑/'''↓
 | align="center" style="padding: 5px 5px; background: #F5F5F5;" |↓/'''↑'''
-| align="center" style="padding: 5px 5px; background: #F5F5F5;" |N
+| align="center" style="padding: 5px 5px; background: #F5F5F5;" |Normal
 | align="center" style="padding: 5px 5px; background: #F5F5F5;" |↓
-| align="center" style="padding: 5px 5px; background: #F5F5F5;" |N/↑
+| align="center" style="padding: 5px 5px; background: #F5F5F5;" |↑
-| align="center" style="padding: 5px 5px; background: #F5F5F5;" |N
+| align="center" style="padding: 5px 5px; background: #F5F5F5;" |Normal/↑
-| align="center" style="padding: 5px 5px; background: #F5F5F5;" |Absent
+| align="center" style="padding: 5px 5px; background: #F5F5F5;" |Present (high titer)
+| align="left" style="padding: 5px 5px; background: #F5F5F5;" |
+*May present primarily with [[hyperthyroidism]]
+|-
+| align="center" style="background:#DCDCDC;" |[[Silent thyroiditis]]
+| align="center" style="padding: 5px 5px; background: #F5F5F5;" | -
+| align="center" style="padding: 5px 5px; background: #F5F5F5;" | -
+| align="center" style="padding: 5px 5px; background: #F5F5F5;" |'''↑/'''↓
+| align="center" style="padding: 5px 5px; background: #F5F5F5;" |↓/'''↑'''
+| align="center" style="padding: 5px 5px; background: #F5F5F5;" |Normal
+| align="center" style="padding: 5px 5px; background: #F5F5F5;" |↓
+| align="center" style="padding: 5px 5px; background: #F5F5F5;" |↑
+| align="center" style="padding: 5px 5px; background: #F5F5F5;" |Normal
+| align="center" style="padding: 5px 5px; background: #F5F5F5;" |Present (high titer)
 | align="left" style="padding: 5px 5px; background: #F5F5F5;" |
-* May present primarily with [[hyperthyroidism]]
+*May present primarily with [[hyperthyroidism]]
 |-
 | rowspan="3" style="background:#DCDCDC;" |[[Primary hypothyroidism]]
@@ Line 120: / Line 158: @@
 | align="center" style="padding: 5px 5px; background: #F5F5F5;" | -
 | align="center" style="padding: 5px 5px; background: #F5F5F5;" | -
-| align="center" style="padding: 5px 5px; background: #F5F5F5;" |'''↑*'''
+| align="center" style="padding: 5px 5px; background: #F5F5F5;" |'''↑'''<small>*
 | align="center" style="padding: 5px 5px; background: #F5F5F5;" |'''''↓'''''
-| align="center" style="padding: 5px 5px; background: #F5F5F5;" |N/'''''↓'''''
+| align="center" style="padding: 5px 5px; background: #F5F5F5;" |Normal/'''''↓'''''
-| align="center" style="padding: 5px 5px; background: #F5F5F5;" |N/↓
+| align="center" style="padding: 5px 5px; background: #F5F5F5;" |Normal/↓
-| align="center" style="padding: 5px 5px; background: #F5F5F5;" |N/'''↑'''
+| align="center" style="padding: 5px 5px; background: #F5F5F5;" |Normal/'''↑'''
-| align="center" style="padding: 5px 5px; background: #F5F5F5;" |N
+| align="center" style="padding: 5px 5px; background: #F5F5F5;" |Normal
 | align="center" style="padding: 5px 5px; background: #F5F5F5;" |Present (high titer)
 | align="left" style="padding: 5px 5px; background: #F5F5F5;" |
@@ Line 133: / Line 171: @@
 | align="center" style="padding: 5px 5px; background: #F5F5F5;" | -
 | align="center" style="padding: 5px 5px; background: #F5F5F5;" | -
-| align="center" style="padding: 5px 5px; background: #F5F5F5;" |N/↑
+| align="center" style="padding: 5px 5px; background: #F5F5F5;" |Normal/↑
-| align="center" style="padding: 5px 5px; background: #F5F5F5;" |N/↓
+| align="center" style="padding: 5px 5px; background: #F5F5F5;" |Normal/↓
-| align="center" style="padding: 5px 5px; background: #F5F5F5;" |N/↓
+| align="center" style="padding: 5px 5px; background: #F5F5F5;" |Normal/↓
-| align="center" style="padding: 5px 5px; background: #F5F5F5;" |N/↓
+| align="center" style="padding: 5px 5px; background: #F5F5F5;" |Normal/↓
-| align="center" style="padding: 5px 5px; background: #F5F5F5;" |N
+| align="center" style="padding: 5px 5px; background: #F5F5F5;" |Normal
-| align="center" style="padding: 5px 5px; background: #F5F5F5;" |N
+| align="center" style="padding: 5px 5px; background: #F5F5F5;" |Normal
 | align="center" style="padding: 5px 5px; background: #F5F5F5;" |Usually present
 | align="left" style="padding: 5px 5px; background: #F5F5F5;" |
-*[[Riedel's thyroiditis]] usually presents with hard and fixed [[Thyroid mass causes|thyroid mass]].
+*[[Riedel's thyroiditis]] usually presents with hard and fixed thyroid mass.
 |-
 | align="center" style="background:#DCDCDC;" |[[Infectious thyroiditis]]
 | align="center" style="padding: 5px 5px; background: #F5F5F5;" | +
 | align="center" style="padding: 5px 5px; background: #F5F5F5;" | +
-| align="center" style="padding: 5px 5px; background: #F5F5F5;" |N
+| align="center" style="padding: 5px 5px; background: #F5F5F5;" |Normal
-| align="center" style="padding: 5px 5px; background: #F5F5F5;" |N
+| align="center" style="padding: 5px 5px; background: #F5F5F5;" |Normal
-| align="center" style="padding: 5px 5px; background: #F5F5F5;" |N
+| align="center" style="padding: 5px 5px; background: #F5F5F5;" |Normal
-| align="center" style="padding: 5px 5px; background: #F5F5F5;" |N
+| align="center" style="padding: 5px 5px; background: #F5F5F5;" |Normal
-| align="center" style="padding: 5px 5px; background: #F5F5F5;" |N
+| align="center" style="padding: 5px 5px; background: #F5F5F5;" |Normal
-| align="center" style="padding: 5px 5px; background: #F5F5F5;" |N
+| align="center" style="padding: 5px 5px; background: #F5F5F5;" |Normal
 | align="center" style="padding: 5px 5px; background: #F5F5F5;" |Absent
 | align="left" style="padding: 5px 5px; background: #F5F5F5;" |
@@ Line 162: / Line 200: @@
 | rowspan="5" align="center" style="padding: 5px 5px; background: #F5F5F5;" |'''↑'''/↓
 | rowspan="5" align="center" style="padding: 5px 5px; background: #F5F5F5;" |'''''↓'''''/↑
-| rowspan="5" align="center" style="padding: 5px 5px; background: #F5F5F5;" |N
+| rowspan="5" align="center" style="padding: 5px 5px; background: #F5F5F5;" |Normal
 | rowspan="5" align="center" style="padding: 5px 5px; background: #F5F5F5;" |↓
-| rowspan="5" align="center" style="padding: 5px 5px; background: #F5F5F5;" |N/'''↑'''
+| rowspan="5" align="center" style="padding: 5px 5px; background: #F5F5F5;" |Normal/'''↑'''
-| rowspan="5" align="center" style="padding: 5px 5px; background: #F5F5F5;" |N
+| rowspan="5" align="center" style="padding: 5px 5px; background: #F5F5F5;" |Normal
 | rowspan="5" align="center" style="padding: 5px 5px; background: #F5F5F5;" |Absent**
 | rowspan="5" align="left" style="padding: 5px 5px; background: #F5F5F5;" |
@@ Line 184: / Line 222: @@
 | align="center" style="padding: 5px 5px; background: #F5F5F5;" | -
 | align="center" style="padding: 5px 5px; background: #F5F5F5;" |'''↑'''
-| align="center" style="padding: 5px 5px; background: #F5F5F5;" |N
+| align="center" style="padding: 5px 5px; background: #F5F5F5;" |Normal
-| align="center" style="padding: 5px 5px; background: #F5F5F5;" |N
+| align="center" style="padding: 5px 5px; background: #F5F5F5;" |Normal
-| align="center" style="padding: 5px 5px; background: #F5F5F5;" |N
+| align="center" style="padding: 5px 5px; background: #F5F5F5;" |Normal
-| align="center" style="padding: 5px 5px; background: #F5F5F5;" |N
+| align="center" style="padding: 5px 5px; background: #F5F5F5;" |Normal
-| align="center" style="padding: 5px 5px; background: #F5F5F5;" |N
+| align="center" style="padding: 5px 5px; background: #F5F5F5;" |Normal
-| align="center" style="padding: 5px 5px; background: #F5F5F5;" |N/'''↑'''
+| align="center" style="padding: 5px 5px; background: #F5F5F5;" |Normal/'''↑'''
 | align="left" style="padding: 5px 5px; background: #F5F5F5;" |
 * Asymptomatic
+|-
 |}
 <br style="clear:left" />''(†)T3RU; Triiodothyronine Resin uptake. (^)TPOAb; [[Thyroid peroxidase]] antibodies. (*)[[TSH]] may be decreased transiently in the [[thyrotoxicosis]]. (**)TPOAb may be present in drug-induced [[Hypothyroidism|hypo]]/[[hyperthyroidism]] such as [[Interferon-alpha]], [[Interleukin 2|interleukin-2]], and [[lithium]].''
-*De Quervain's thyroiditis can be differentiated from the conditions causing thyrotoxicosis on the basis of following features:
-{| style="border: 0px; font-size: 90%; margin: 3px;" align="center"
-! colspan="1" rowspan="1" style="background: #4479BA; padding: 5px 5px;" | {{fontcolor|#FFFFFF|Cause of thyrotoxicosis}}
-! colspan="1" rowspan="1" style="background: #4479BA; padding: 5px 5px;" | {{fontcolor|#FFFFFF|TSH receptor Antibodies}}
-! colspan="1" rowspan="1" style="background: #4479BA; padding: 5px 5px;" | {{fontcolor|#FFFFFF|Thyroid US}}
-! colspan="1" rowspan="1" style="background: #4479BA; padding: 5px 5px;" | {{fontcolor|#FFFFFF|Color flow Doppler}}
-! colspan="1" rowspan="1" style="background: #4479BA; padding: 5px 5px;" | {{fontcolor|#FFFFFF|Radioactive iodine uptake/Scan}}
-! colspan="1" rowspan="1" style="background: #4479BA; padding: 5px 5px;" | {{fontcolor|#FFFFFF|Other features}}
-|-
-| colspan="1" rowspan="1" style="background: #4479BA; padding: 5px 5px;" |{{fontcolor|#FFFFFF|Subacute thyroiditis}}
-| style="padding: 5px 5px; background: #F5F5F5;" | -
-| style="padding: 5px 5px; background: #F5F5F5;" | Heterogeneous hypoechoic areas
-| style="padding: 5px 5px; background: #F5F5F5;" | Reduced/absent flow
-| style="padding: 5px 5px; background: #F5F5F5;" | ↓
-| style="padding: 5px 5px; background: #F5F5F5;" | Neck pain, fever, and<br> elevated inflammatory index
-|-
-| colspan="1" rowspan="1" style="background: #4479BA; padding: 5px 5px;" |{{fontcolor|#FFFFFF|Graves' disease}}
-| style="padding: 5px 5px; background: #F5F5F5;" | +
-| style="padding: 5px 5px; background: #F5F5F5;" | Hypoechoic pattern
-| style="padding: 5px 5px; background: #F5F5F5;" | ↑
-| style="padding: 5px 5px; background: #F5F5F5;" | ↑
-| style="padding: 5px 5px; background: #F5F5F5;" | Ophthalmopathy, dermopathy, acropachy
-|-
-| colspan="1" rowspan="1" style="background: #4479BA; padding: 5px 5px;" |{{fontcolor|#FFFFFF|Toxic nodular goiter}}
-| style="padding: 5px 5px; background: #F5F5F5;" | -
-| style="padding: 5px 5px; background: #F5F5F5;" | Multiple nodules
-| style="padding: 5px 5px; background: #F5F5F5;" | -
-| style="padding: 5px 5px; background: #F5F5F5;" | Hot nodules at thyroid scan
-| style="padding: 5px 5px; background: #F5F5F5;" | -
-|-
-| colspan="1" rowspan="1" style="background: #4479BA; padding: 5px 5px;" |{{fontcolor|#FFFFFF|Toxic adenoma}}
-| style="padding: 5px 5px; background: #F5F5F5;" | -
-| style="padding: 5px 5px; background: #F5F5F5;" | Single nodule
-| style="padding: 5px 5px; background: #F5F5F5;" | -
-| style="padding: 5px 5px; background: #F5F5F5;" | Hot nodule
-| style="padding: 5px 5px; background: #F5F5F5;" | -
-|-
-| colspan="1" rowspan="1" style="background: #4479BA; padding: 5px 5px;" |{{fontcolor|#FFFFFF|Painless thyroiditis}}
-| style="padding: 5px 5px; background: #F5F5F5;" | -
-| style="padding: 5px 5px; background: #F5F5F5;" | Hypoechoic pattern
-| style="padding: 5px 5px; background: #F5F5F5;" | Reduced/absent flow
-| style="padding: 5px 5px; background: #F5F5F5;" | ↓
-| style="padding: 5px 5px; background: #F5F5F5;" | -
-|-
-| colspan="1" rowspan="1" style="background: #4479BA; padding: 5px 5px;" |{{fontcolor|#FFFFFF|Amiodarone induced thyroiditis-Type 1}}
-| style="padding: 5px 5px; background: #F5F5F5;" | -
-| style="padding: 5px 5px; background: #F5F5F5;" | Diffuse or nodular goiter
-| style="padding: 5px 5px; background: #F5F5F5;" | ↓/Normal/↑
-| style="padding: 5px 5px; background: #F5F5F5;" | ↓ but higher than in Type 2
-| style="padding: 5px 5px; background: #F5F5F5;" | High urinary iodine
-|-
-| colspan="1" rowspan="1" style="background: #4479BA; padding: 5px 5px;" |{{fontcolor|#FFFFFF|Amiodarone induced thyroiditis-Type 2}}
-| style="padding: 5px 5px; background: #F5F5F5;" | -
-| style="padding: 5px 5px; background: #F5F5F5;" | Normal
-| style="padding: 5px 5px; background: #F5F5F5;" | Absent
-| style="padding: 5px 5px; background: #F5F5F5;" | ↓/absent
-| style="padding: 5px 5px; background: #F5F5F5;" | High urinary iodine
-|-
-| colspan="1" rowspan="1" style="background: #4479BA; padding: 5px 5px;" |{{fontcolor|#FFFFFF|Central hyperthyroidism}}
-| style="padding: 5px 5px; background: #F5F5F5;" | -
-| style="padding: 5px 5px; background: #F5F5F5;" | Diffuse or nodular goiter
-| style="padding: 5px 5px; background: #F5F5F5;" | Normal/↑
-| style="padding: 5px 5px; background: #F5F5F5;" | ↑
-| style="padding: 5px 5px; background: #F5F5F5;" | Inappropriately normal or high TSH
-|-
-| colspan="1" rowspan="1" style="background: #4479BA; padding: 5px 5px;" |{{fontcolor|#FFFFFF|Trophoblastic disease}}
-| style="padding: 5px 5px; background: #F5F5F5;" | -
-| style="padding: 5px 5px; background: #F5F5F5;" | Diffuse or nodular goiter
-| style="padding: 5px 5px; background: #F5F5F5;" | Normal/↑
-| style="padding: 5px 5px; background: #F5F5F5;" | ↑
-| style="padding: 5px 5px; background: #F5F5F5;" | -
-|-
-| colspan="1" rowspan="1" style="background: #4479BA; padding: 5px 5px;" |{{fontcolor|#FFFFFF|Factitious thyrotoxicosis}}
-| style="padding: 5px 5px; background: #F5F5F5;" | -
-| style="padding: 5px 5px; background: #F5F5F5;" | Variable
-| style="padding: 5px 5px; background: #F5F5F5;" | Reduced/absent flow
-| style="padding: 5px 5px; background: #F5F5F5;" | ↓
-| style="padding: 5px 5px; background: #F5F5F5;" | ↓ serum thyroglobulin
-|-
-| colspan="1" rowspan="1" style="background: #4479BA; padding: 5px 5px;" |{{fontcolor|#FFFFFF|Struma ovarii}}
-| style="padding: 5px 5px; background: #F5F5F5;" | -
-| style="padding: 5px 5px; background: #F5F5F5;" | Variable
-| style="padding: 5px 5px; background: #F5F5F5;" | Reduced/absent flow
-| style="padding: 5px 5px; background: #F5F5F5;" | ↓
-| style="padding: 5px 5px; background: #F5F5F5;" | Abdominal RAIU
-|}
 ==References==
 {{Reflist|2}}

De Quervain's thyroiditis from other diseases: Difference between revisions

Revision as of 20:36, 27 September 2017

Overview

Differentiating De Quervain's thyroiditis from other diseases

References

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