De Quervain's thyroiditis from other diseases: Difference between revisions
Jump to navigation
Jump to search
No edit summary |
No edit summary |
||
Line 232: | Line 232: | ||
|} | |} | ||
<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]].'' | <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]].'' | ||
===Differentiating de Quervain's thyroiditis from other causes of thyrotoxicosis=== | |||
*Hashimoto's thyroiditis can initially present with thyrotoxicosis (hashitoxicosis) which must be differentiated from other causes of thyrotoxicosis.<ref name="pmid16734054">{{cite journal |vauthors=Bindra A, Braunstein GD |title=Thyroiditis |journal=Am Fam Physician |volume=73 |issue=10 |pages=1769–76 |year=2006 |pmid=16734054 |doi= |url=}}</ref><ref name="pmid19949140">{{cite journal |vauthors=McDermott MT |title=In the clinic. Hypothyroidism |journal=Ann. Intern. Med. |volume=151 |issue=11 |pages=ITC61 |year=2009 |pmid=19949140 |doi=10.7326/0003-4819-151-11-200912010-01006 |url=}}</ref><ref name="urlThyroiditis — NEJM">{{cite web |url=http://www.nejm.org/doi/full/10.1056/NEJMra021194 |title=Thyroiditis — NEJM |format= |work= |accessdate=}}</ref><ref name="pmid18177256">{{cite journal |vauthors=Aoki Y, Belin RM, Clickner R, Jeffries R, Phillips L, Mahaffey KR |title=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) |journal=Thyroid |volume=17 |issue=12 |pages=1211–23 |year=2007 |pmid=18177256 |doi=10.1089/thy.2006.0235 |url=}}</ref><ref name="pmid18415684">{{cite journal |vauthors=Lania A, Persani L, Beck-Peccoz P |title=Central hypothyroidism |journal=Pituitary |volume=11 |issue=2 |pages=181–6 |year=2008 |pmid=18415684 |doi=10.1007/s11102-008-0122-6 |url=}}</ref><ref name="pmid25905413">{{cite journal |vauthors=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 |title=Clinical Strategies in the Testing of Thyroid Function |journal= |volume= |issue= |pages= |year= |pmid=25905413 |doi= |url=}}</ref><ref name="urlClinical Finding and Thyroid Function in Women with Struma Ovarii">{{cite web |url=https://www.hindawi.com/archive/2013/717584/ |title=Clinical Finding and Thyroid Function in Women with Struma Ovarii |format= |work= |accessdate=}}</ref><ref name="pmid25146390">{{cite journal |vauthors=Vaidya B, Pearce SH |title=Diagnosis and management of thyrotoxicosis |journal=BMJ |volume=349 |issue= |pages=g5128 |year=2014 |pmid=25146390 |doi= |url=}}</ref><ref name="urlThink thyrotoxicosis factitia - measure thyroglobulin | The BMJ">{{cite web |url=http://www.bmj.com/content/349/bmj.g5128/rr/763450 |title=Think thyrotoxicosis factitia - measure thyroglobulin | The BMJ |format= |work= |accessdate=}}</ref> | |||
{| class="wikitable" align="center" style="border: 0px; margin: 3px;" | |||
! colspan="2" rowspan="2" align="center" style="background: #4479BA; color: #FFFFFF; " |Disease | |||
! colspan="2" align="center" style="background: #4479BA; color: #FFFFFF; " |History and symptoms | |||
! colspan="8" align="center" style="background: #4479BA; color: #FFFFFF; " |Laboratory findings | |||
! rowspan="2" align="center" style="background: #4479BA; color: #FFFFFF; " |Additional findings | |||
|- | |||
! align="center" style="background: #4479BA; color: #FFFFFF; " |<small> Fever | |||
! align="center" style="background: #4479BA; color: #FFFFFF; " |<small> Pain | |||
! align="center" style="background: #4479BA; color: #FFFFFF; " |<small> TSH | |||
! 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<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> TSH Receptor Antibody | |||
! align="center" style="background: #4479BA; color: #FFFFFF; " |<small> TPOAb^ | |||
|- | |||
| 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;" |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;" |Absent | |||
| align="center" style="padding: 5px 5px; background: #F5F5F5;" |Low/absent | |||
| align="left" style="padding: 5px 5px; background: #F5F5F5;" | | |||
*May present with [[hypothyroidism]] | |||
|- | |||
| rowspan="4" style="background:#DCDCDC;" |[[Thyroiditis]] | |||
| align="center" style="background:#DCDCDC;" |[[Hashimoto's thyroiditis]] (Hashitoxicosis) | |||
| 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;" |Normal/'''''↓''''' | |||
| align="center" style="padding: 5px 5px; background: #F5F5F5;" |Normal/↓ | |||
| align="center" style="padding: 5px 5px; background: #F5F5F5;" |Normal/'''↑''' | |||
| 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 be accompanied by other [[autoimmune diseases]] | |||
|- | |||
| 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;" |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;" |Absent | |||
| align="center" style="padding: 5px 5px; background: #F5F5F5;" |Present (high titer) | |||
| align="left" style="padding: 5px 5px; background: #F5F5F5;" | | |||
*May present with [[hypothyroidism]] | |||
|- | |||
| 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;" |Absent | |||
| align="center" style="padding: 5px 5px; background: #F5F5F5;" |Present (high titer) | |||
| align="left" style="padding: 5px 5px; background: #F5F5F5;" | | |||
*May present with [[hypothyroidism]] | |||
|- | |||
| rowspan="2" style="background:#DCDCDC;" |[[hyperthyroidism|Primary hyperthyroidism]] | |||
| align="center" style="background:#DCDCDC;" |[[Grave's disease]] | |||
| 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 | |||
| align="center" style="padding: 5px 5px; background: #F5F5F5;" |Absent | |||
| align="left" style="padding: 5px 5px; background: #F5F5F5;" | | |||
* Patient may have opthalmopathy and dermopathy | |||
|- | |||
| align="center" style="background:#DCDCDC;" |[[Toxic thyroid nodule]] | |||
| 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;" |↑(hot nodule) | |||
| align="center" style="padding: 5px 5px; background: #F5F5F5;" |Normal/'''↑''' | |||
| 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;" |Absent | |||
| align="left" style="padding: 5px 5px; background: #F5F5F5;" | | |||
- | |||
|- | |||
| rowspan="1" style="background:#DCDCDC;" |[[Hyperthyroidism|Secondary hyperthyroidism]] | |||
| align="center" style="background:#DCDCDC;" |[[Pituitary adenoma]] | |||
| 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;" |Normal/'''↑''' | |||
| 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;" |Absent | |||
| align="left" style="padding: 5px 5px; background: #F5F5F5;" | | |||
*Inappropriately normal or increased TSH | |||
|- | |||
| rowspan="1" style="background:#DCDCDC;" |[[Tertiary hyperthyroidism]] | |||
| align="center" style="background:#DCDCDC;" |[[Hyperthyroidism|Tertiary hyperthyroidism]] | |||
| 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;" |Normal/'''↑''' | |||
| align="center" style="padding: 5px 5px; background: #F5F5F5;" |↑ | |||
| align="center" style="padding: 5px 5px; background: #F5F5F5;" |Absent | |||
| align="center" style="padding: 5px 5px; background: #F5F5F5;" |Absent | |||
| align="left" style="padding: 5px 5px; background: #F5F5F5;" | | |||
*Inappropriately normal or increased TSH | |||
|- | |||
| rowspan="2" style="background:#DCDCDC;" |Drug induced | |||
| align="center" style="background:#DCDCDC;" |[[Amiodarone| Amiodarone type 1]] | |||
| 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;" |Normal/'''↑''' | |||
| 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;" |Absent | |||
| align="left" style="padding: 5px 5px; background: #F5F5F5;" | | |||
*High urinary iodine | |||
|- | |||
| align="center" style="background:#DCDCDC;" |[[Amiodarone|Amiodarone type 2]] | |||
| 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;" |Absent/↓ | |||
| align="center" style="padding: 5px 5px; background: #F5F5F5;" |Normal/'''↑''' | |||
| 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;" |Absent | |||
| align="left" style="padding: 5px 5px; background: #F5F5F5;" | | |||
*High urinary iodine | |||
|- | |||
| rowspan="3" style="background:#DCDCDC;" |Others | |||
| align="center" style="background:#DCDCDC;" |[[Factitious thyrotoxicosis]] | |||
| 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;" |Absent | |||
| align="center" style="padding: 5px 5px; background: #F5F5F5;" |Absent | |||
| align="left" style="padding: 5px 5px; background: #F5F5F5;" | | |||
*Decreased thyroglobulin | |||
|- | |||
| align="center" style="background:#DCDCDC;" |[[Trophoblastic disease]] | |||
| 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;" |Absent | |||
| align="center" style="padding: 5px 5px; background: #F5F5F5;" |Absent | |||
| align="left" style="padding: 5px 5px; background: #F5F5F5;" | | |||
- | |||
|- | |||
| align="center" style="background:#DCDCDC;" |[[Struma ovarii]] | |||
| 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;" |Absent | |||
| align="center" style="padding: 5px 5px; background: #F5F5F5;" |Absent | |||
| align="left" style="padding: 5px 5px; background: #F5F5F5;" | | |||
- | |||
|- | |||
|} | |||
<small>''(†)T3RU; Triiodothyronine Resin uptake. (^)TPOAb; [[Thyroid peroxidase]] antibodies.''</small> | |||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} |
Revision as of 17:06, 5 October 2017
De Quervain's thyroiditis Microchapters |
Differentiating De Quervain's thyroiditis from other Diseases |
---|
Diagnosis |
Treatment |
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 |
|
|
| |
Hashimoto's thyroiditis |
|
|
|
|
Silent thyroiditis |
|
|
|
|
Postpartum thyroiditis |
|
|
|
|
Riedel's thyroiditis |
|
|
|
|
Suppurative thyroiditis (Infectious Thyroiditis) |
|
|
|
|
- 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 | ||||||||
---|---|---|---|---|---|---|---|---|---|---|---|
Fever | Pain | TSH | Free T4 | T3 | T3RU† | Thyroglobin | TRH | TPOAb^ | |||
Transient hypothyroidism | Subacute (de Quervain's) thyroiditis | +/- | +/- | ↑/↓ | ↓/↑ | Normal | ↓ | ↑ | Normal | Low/absent |
|
Postpartum thyroiditis | +/- | +/- | ↑/↓ | ↓/↑ | Normal | ↓ | ↑ | Normal/↑ | Present (high titer) |
| |
Silent thyroiditis | - | - | ↑/↓ | ↓/↑ | Normal | ↓ | ↑ | Normal | Present (high titer) |
| |
Primary hypothyroidism | Autoimmune (Hashimoto's thyroiditis) | - | - | ↑* | ↓ | Normal/↓ | Normal/↓ | Normal/↑ | Normal | Present (high titer) |
|
Riedel's thyroiditis | - | - | Normal/↑ | Normal/↓ | Normal/↓ | Normal/↓ | Normal | Normal | Usually present |
| |
Suppurative thyroiditis (Infectious Thyroiditis) | + | + | Normal | Normal | Normal | Normal | Normal | Normal | Absent |
| |
Others | Drug-induced | - | - | ↑/↓ | ↓/↑ | Normal | ↓ | Normal/↑ | Normal | Absent** |
|
Radiation-induced | |||||||||||
Trauma induced | |||||||||||
Radioiodine induced | |||||||||||
Thyroidectomy | |||||||||||
Subclinical hypothyroidism | - | - | ↑ | Normal | Normal | Normal | Normal | Normal | Normal/↑ |
|
(†)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.
Differentiating de Quervain's thyroiditis from other causes of thyrotoxicosis
- Hashimoto's thyroiditis can initially present with thyrotoxicosis (hashitoxicosis) which must be differentiated from other causes of thyrotoxicosis.[2][3][1][4][5][6][7][8][9]
Disease | History and symptoms | Laboratory findings | Additional findings | |||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Fever | Pain | TSH | Free T4 | T3 | T3RU† | Thyroglobin | TRH | TSH Receptor Antibody | TPOAb^ | |||
Subacute (de Quervain's) thyroiditis | +/- | +/- | ↑/↓ | ↓/↑ | Normal | ↓ | ↑ | Normal | Absent | Low/absent |
| |
Thyroiditis | Hashimoto's thyroiditis (Hashitoxicosis) | - | - | ↑* | ↓ | Normal/↓ | Normal/↓ | Normal/↑ | Normal | Absent | Present (high titer) |
|
Postpartum thyroiditis | +/- | +/- | ↑/↓ | ↓/↑ | Normal | ↓ | ↑ | Normal/↑ | Absent | Present (high titer) |
| |
Silent thyroiditis | - | - | ↑/↓ | ↓/↑ | Normal | ↓ | ↑ | Normal | Absent | Present (high titer) |
| |
Primary hyperthyroidism | Grave's disease | - | - | ↓ | ↑ | Normal/↑ | ↑ | ↑ | Normal | Present | Absent |
|
Toxic thyroid nodule | - | - | ↓ | ↑ | Normal/↑ | ↑(hot nodule) | Normal/↑ | Normal | Absent | Absent |
- | |
Secondary hyperthyroidism | Pituitary adenoma | - | - | ↑ | ↑ | Normal/↑ | ↑ | Normal/↑ | Normal | Absent | Absent |
|
Tertiary hyperthyroidism | Tertiary hyperthyroidism | - | - | ↑ | ↑ | ↑ | ↑ | Normal/↑ | ↑ | Absent | Absent |
|
Drug induced | Amiodarone type 1 | - | - | ↓ | ↑ | Normal/↑ | ↓ | Normal/↑ | Normal | Absent | Absent |
|
Amiodarone type 2 | - | - | ↓ | ↑ | Normal/↑ | Absent/↓ | Normal/↑ | Normal | Absent | Absent |
| |
Others | Factitious thyrotoxicosis | - | - | ↓ | ↑ | Normal/↑ | ↓ | ↓ | Normal | Absent | Absent |
|
Trophoblastic disease | - | - | ↓ | ↑ | Normal/↑ | ↑ | - | Normal | Absent | Absent |
- | |
Struma ovarii | - | - | ↓ | ↑ | Normal/↑ | ↓ | - | Normal | Absent | Absent |
- |
(†)T3RU; Triiodothyronine Resin uptake. (^)TPOAb; Thyroid peroxidase antibodies.
References
- ↑ 1.0 1.1 1.2 "Thyroiditis — NEJM".
- ↑ 2.0 2.1 Bindra A, Braunstein GD (2006). "Thyroiditis". Am Fam Physician. 73 (10): 1769–76. PMID 16734054.
- ↑ 3.0 3.1 McDermott MT (2009). "In the clinic. Hypothyroidism". Ann. Intern. Med. 151 (11): ITC61. doi:10.7326/0003-4819-151-11-200912010-01006. PMID 19949140.
- ↑ 4.0 4.1 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.
- ↑ 5.0 5.1 Lania A, Persani L, Beck-Peccoz P (2008). "Central hypothyroidism". Pituitary. 11 (2): 181–6. doi:10.1007/s11102-008-0122-6. PMID 18415684.
- ↑ 6.0 6.1 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.
- ↑ "Clinical Finding and Thyroid Function in Women with Struma Ovarii".
- ↑ Vaidya B, Pearce SH (2014). "Diagnosis and management of thyrotoxicosis". BMJ. 349: g5128. PMID 25146390.
- ↑ "Think thyrotoxicosis factitia - measure thyroglobulin | The BMJ".