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Friday, 29 November 2013

Thyroid Disease : Acute thyroiditis – The Symptoms

Thyroid is one of the largest endocrine glands found in the neck, below the Adam’s Apple with the function of regulating the body use of energy, make of proteins by producing its hormones as a result of the stimulation of thyroid-stimulating hormone (TSH) produced by the anterior pituitary.
Thyroid disease is defined as a condition of malfunction of thyroid. Hyperthyroidism is a condition in which the thyroid gland is over active and produces too much thyroid hormones. Hypothyroidism is a condition in which the thyroid gland is under active and produces very little thyroid hormones. Thyroid cancer is defined as condition in which the cells in the thyroid gland have become cancerous.
Acute thyroiditis is defined as a condition of as a result of relatively high amount of iodine in the tissue causes of microbial inflammatory thyroiditis, pyrogenic thyroiditis and bacterial thyroiditis. Acute infectious thyroiditis is very rare, accounting for about 0.1-0.7% of all thyroiditis.
A. Symptoms
1. Fever and swelling and tenderness in the neck
There is a report of a 40-year-old women complained of fever and left neck swelling for 20 days. Magnetic resonance imaging showed left neck inflammatory changes. FNA revealed pus and inflammatory cells infiltration and a 44-year-old man presented with anterior neck tender swelling and odynophagia for 12 days. He had thyrotoxicosis(1).
2. Infectious hip arthritis, spondylitis and Roth’s spots
There is a report a 61-year-old man with acute right-sided suppurative thyroiditis without pyriform sinus fistula. He also showed infectious hip arthritis, spondylitis and Roth’s spots(2).
3. Chills, dysuria and recent painful neck swelling
There is a report of a case of an 81-yr-old woman with acute suppurative thyroiditis secondary to Escherichia coli (E. coli) infection. The patient presented with fevers, chills, dysuria and recent painful neck swelling(3).
4. Firm, livid, hardly mobile cervical swelling
There is a report of a case of a 75-year-old female patient with acute suppurative thyroiditis and right lobe thyroid abscess caused by Klebsiella spp. The patient had a firm, livid, hardly mobile cervical swelling. Axial computed tomography image showed soft-tissue swelling, an abscess in the right thyroid lobe and swelling of the thyroid gland(4).
5. Impaired vocal cord mobility
there is a report of a 41-year-old woman was initially seen with a unilateral vocal cord paralysis resulting from acute suppurative thyroiditis(5).
6. Swollen, red, hot, and tender, and limited neck movement
There is a report of a healthy 6-year-old boy had continuous fever for 6 days before admission to our hospital. His general condition was good except for pyrexia. The left lobe of the thyroid gland was swollen, red, hot, and tender, and neck movement was limited(6).
7. Severe odynophagia and dysphagia, fever, chills, sore throat and right ear pain
There is a report of a case of suppurative thyroiditis caused by Salmonella enteritidis of an 82 year-old man with diabetes mellitus type 2 and a history of steroid treatment who presented with severe odynophagia and dysphagia associated with fever, chills, sore throat and right ear pain(6a).
8. Dysphonia, myalgia, swelling of the small joints of the hands, weight loss, and erythematous malar rash
There is a report of an unusual case of acute suppurative thyroiditis associated with juvenile systemic lupus erythematosus (JSLE) onset. A 10 year-old girl presented with a painful voluminous swelling in the anterior cervical region with fever and dysphagia. She also had dysphonia, myalgia, swelling of the small joints of the hands, weight loss, and erythematous malar rash(6b).
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Sources
(1) http://www.ncbi.nlm.nih.gov/pubmed/23435638
(2) http://www.ncbi.nlm.nih.gov/pubmed/22129504
(3) http://www.ncbi.nlm.nih.gov/pubmed/17259797
(4) http://www.ncbi.nlm.nih.gov/pubmed/19499695
(5) http://www.ncbi.nlm.nih.gov/pubmed/9142526
(6) http://www.ncbi.nlm.nih.gov/pubmed/20424880
(6a) http://www.ncbi.nlm.nih.gov/pubmed/22069108
(6b) http://www.ncbi.nlm.nih.gov/pubmed/19554814