Sandbox:ddx graves: Difference between revisions
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! style="background: #4479BA; padding: 5px 5px;" | ! colspan="2" rowspan="1" style="background: #4479BA; padding: 5px 5px;" | {{fontcolor|#FFFFFF|Disease}} | ||
|{{fontcolor|#FFFFFF|Findings}}Findings | |||
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| style="background: #4479BA; padding: 5px 5px;" rowspan=5 colspan=1 |{{fontcolor|#FFFFFF|Thyroiditis}} | | style="background: #4479BA; padding: 5px 5px;" rowspan=5 colspan=1 |{{fontcolor|#FFFFFF|Thyroiditis}} | ||
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| style="background: #4479BA; padding: 5px 5px;" | | colspan="2" rowspan="1" style="background: #4479BA; padding: 5px 5px;" |{{fontcolor|#FFFFFF|Hashitoxicosis }} | ||
|It is autoimmune thyroid disease who initially present with hyperthyroidism and a high radioiodine uptake caused by TSH-receptor antibodies similar to Graves' disease followed by the development of hypothyroidism due to infiltration of thyroid gland with lymphocytes and resultant autoimmune-mediated destruction of thyroid tissue similar to chronic lymphocytic thyroiditis.<ref name="pmid5171000" /> | |||
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| style="background: #4479BA; padding: 5px 5px;" | | colspan="2" rowspan="1" style="background: #4479BA; padding: 5px 5px;" |{{fontcolor|#FFFFFF|Toxic adenoma and toxic multinodular goiter}} | ||
|Toxic adenoma and toxic multinodular goiter are result of focal/diffuse hyperplasia of thyroid follicular cells independent to TSH regulation. Finding single or multiple nodules in physical examination or thyroid scan.<ref name="pmid2040867" /> | |||
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| style="background: #4479BA; padding: 5px 5px;" | | colspan="2" rowspan="1" style="background: #4479BA; padding: 5px 5px;" |{{fontcolor|#FFFFFF|Iodine-induced hyperthyroidism }} | ||
|It is uncommon but, can develop after an iodine load, such as administration of contrast agents used for angiography or computed tomography (CT) or iodine-rich drugs such as amiodarone. | |||
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| style="background: #4479BA; padding: 5px 5px;" | | colspan="2" rowspan="1" style="background: #4479BA; padding: 5px 5px;" |{{fontcolor|#FFFFFF|Trophoblastic disease and germ cell tumors }} | ||
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Revision as of 17:12, 14 December 2016
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| Disease | Findings |
|---|---|
| Direct chemical toxicity with inflammation | Amiodarone, sunitinib, pazopanib, axitinib, and other tyrosine kinase inhibitors may also be associated with a destructive thyroiditis. |
| Direct chemical toxicity with inflammation | Patients who treated with radioiodine, may develops thyroid pain and tenderness 5 to 10 days later, due to radiation-induced injury and necrosis of thyroid follicular cells and associated inflammation. |
| Drugs that interfere with the immune system | nterferon-alfa is well known for associated thyroid abnormality. It mostly lead to development of de novo antithyroid antibodies. |
| Lithium | Patients treated with lithium are at high risk to develop painless thyroiditis and Graves' disease. |
| Palpation thyroiditis | Manipulation of thyroid gland during thyroid biopsy or neck surgery and vigorous palpation during physical examination may cause transient hyperthyroidism. |
| Exogenous and ectopic hyperthyroidism | Factitious ingestion of thyroid hormone |
| Acute hyperthyroidism from a levothyroxine overdose | |
| Struma ovarii | |
| Functional thyroid cancer metastases | |
| Hashitoxicosis | It is autoimmune thyroid disease who initially present with hyperthyroidism and a high radioiodine uptake caused by TSH-receptor antibodies similar to Graves' disease followed by the development of hypothyroidism due to infiltration of thyroid gland with lymphocytes and resultant autoimmune-mediated destruction of thyroid tissue similar to chronic lymphocytic thyroiditis.[1] |
| Toxic adenoma and toxic multinodular goiter | Toxic adenoma and toxic multinodular goiter are result of focal/diffuse hyperplasia of thyroid follicular cells independent to TSH regulation. Finding single or multiple nodules in physical examination or thyroid scan.[2] |
| Iodine-induced hyperthyroidism | It is uncommon but, can develop after an iodine load, such as administration of contrast agents used for angiography or computed tomography (CT) or iodine-rich drugs such as amiodarone. |
| Trophoblastic disease and germ cell tumors |
| Disease | FindingsFindings | |
|---|---|---|
| Thyroiditis | Direct chemical toxicity with inflammation | Amiodarone, sunitinib, pazopanib, axitinib, and other tyrosine kinase inhibitors may also be associated with a destructive thyroiditis. |
| Radiation thyroiditis | Patients who treated with radioiodine, may develops thyroid pain and tenderness 5 to 10 days later, due to radiation-induced injury and necrosis of thyroid follicular cells and associated inflammation. | |
| Drugs that interfere with the immune system | Interferon-alfa is well known for associated thyroid abnormality. It mostly lead to development of de novo antithyroid antibodies. | |
| Lithium | Patients treated with lithium are at high risk to develop painless thyroiditis and Graves' disease. | |
| Palpation thyroiditis | Manipulation of thyroid gland during thyroid biopsy or neck surgery and vigorous palpation during physical examination may cause transient hyperthyroidism. | |
| Exogenous and ectopic hyperthyroidism | Factitious ingestion of thyroid hormone | |
| Acute hyperthyroidism from a levothyroxine overdose | ||
| Struma ovarii | ||
| Functional thyroid cancer metastases | ||
| Hashitoxicosis | It is autoimmune thyroid disease who initially present with hyperthyroidism and a high radioiodine uptake caused by TSH-receptor antibodies similar to Graves' disease followed by the development of hypothyroidism due to infiltration of thyroid gland with lymphocytes and resultant autoimmune-mediated destruction of thyroid tissue similar to chronic lymphocytic thyroiditis.[1] | |
| Toxic adenoma and toxic multinodular goiter | Toxic adenoma and toxic multinodular goiter are result of focal/diffuse hyperplasia of thyroid follicular cells independent to TSH regulation. Finding single or multiple nodules in physical examination or thyroid scan.[2] | |
| Iodine-induced hyperthyroidism | It is uncommon but, can develop after an iodine load, such as administration of contrast agents used for angiography or computed tomography (CT) or iodine-rich drugs such as amiodarone. | |
| Trophoblastic disease and germ cell tumors | ||
- ↑ 1.0 1.1 Fatourechi V, McConahey WM, Woolner LB (1971). "Hyperthyroidism associated with histologic Hashimoto's thyroiditis". Mayo Clin. Proc. 46 (10): 682–9. PMID 5171000.
- ↑ 2.0 2.1 Laurberg P, Pedersen KM, Vestergaard H, Sigurdsson G (1991). "High incidence of multinodular toxic goitre in the elderly population in a low iodine intake area vs. high incidence of Graves' disease in the young in a high iodine intake area: comparative surveys of thyrotoxicosis epidemiology in East-Jutland Denmark and Iceland". J. Intern. Med. 229 (5): 415–20. PMID 2040867.