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{{familytree | | | | |!| | | | |!| | | | | | | H01 | | | | |!| | | |!|H01=RAIU*}}
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{{familytree | | | | E01 | | | E04 | | | | E02 | | E03 | | E04 | | |E06 |E01=Suppurative thyroiditis|E02=Increased|E03=Decreased|E04=De Quervain's thyroiditis|E06=Riedel's thyroiditis††}}
{{familytree | | | | E01 | | | E04 | | | | E02 | | E03 | | E04 | | |E06 |E01=Suppurative thyroiditis|E02=Increased|E03=Decreased|E04=Hashimoto's thyroiditis|E06=Riedel's thyroiditis††}}
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{{familytree | | | | | | | | | | | | | | | |!| | | |!| }}
{{familytree | | | | | | | | | | | | | | | F01 | | F02 |F01=Graves disease†|F02=
{{familytree | | | | | | | | | | | | | | | F01 | | F02 |F01=Graves disease†|F02=

Revision as of 19:55, 5 October 2017

Postpartum thyroiditis Microchapters

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sunny Kumar MD [2], Furqan M M. M.B.B.S[3]

Overview

There are no established criteria for the diagnosis of PPT but it can be diagnosed on basis of level of TSH, free T, free T3, radio-iodine, uptake presence of anit-TPO antibodies and absence of TSH receptor antibodies depending on the phase of disease[1]

Diagnostic Criteria

  • There are no established criteria for the diagnosis of PPT but it can be diagnosed on basis of level of TSH, free T, free T3, radio-iodine, uptake presence of anit-TPO antibodies and absence of TSH receptor antibodies depending on the phase of disease[1].
  • Hyperthyroid phase: Set of following laboratory values on one or more occasions
  • TSH: low or suppresed
  • Anti-TPO antibodies: Postive
  • TSH-receptor antibodies: Negative
  • Free T4: Typical raised but may be normal.
  • Free T3: Raised or normal with or without raised FT4.
  • Radio-iodine uptake: Decreased.
  • Hypothyroid phase:
  • TSH: >3.6 mU/L
  • Anti-TPO antibodies: Postive
  • Free T4: <8 pmol/l
  • Free T3: <4.2 pmol/l
  • Radio-iodine uptake: Decreased.
  • Thyroid gland tenderness: Non-tender but may be tender sometime.[2]
  • ESR: Normal[3]

Stepwise clinical diagnosis of Postpartum thyroiditis

The following flowchart describes the clinical approach to the diagnosis of thyroiditis.

 
 
 
 
 
 
 
 
 
 
 
Neck pain
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Yes
 
 
 
 
 
 
 
 
 
 
No
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
RAIU*
 
 
 
 
 
 
 
 
 
 
Presenting symptoms and TFTs‡
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Increased
 
 
Decreased
 
 
 
 
 
Hyperthyroid
 
 
 
Hypothyroid
 
Euthyroid
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
RAIU*
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Suppurative thyroiditis
 
 
Hashimoto's thyroiditis
 
 
 
Increased
 
Decreased
 
Hashimoto's thyroiditis
 
 
Riedel's thyroiditis††
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Graves disease†
 
Silent thyroiditis


Postpartum thyroiditis

‡TFT; Thyroid function tests(TSH, T4, and T3), †Grave's disease is not a thyroiditis, *RAIU; Radioiodine uptake.††One third of Riedel's thyroiditis presents with hypothyroidism.
Table modified from [4]

References

  1. 1.0 1.1 Stagnaro-Green A (2002). "Clinical review 152: Postpartum thyroiditis". J Clin Endocrinol Metab. 87 (9): 4042–7. doi:10.1210/jc.2002-020524. PMID 12213841.
  2. Stagnaro-Green A (2002). "Clinical review 152: Postpartum thyroiditis". J Clin Endocrinol Metab. 87 (9): 4042–7. doi:10.1210/jc.2002-020524. PMID 12213841.
  3. Stagnaro-Green A (2002). "Clinical review 152: Postpartum thyroiditis". J Clin Endocrinol Metab. 87 (9): 4042–7. doi:10.1210/jc.2002-020524. PMID 12213841.
  4. "Thyroiditis: Differential Diagnosis and Management - American Family Physician".

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