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Friday, 29 November 2013

Thyroid Disease : Acute thyroiditis – The Diseases associated to

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 (Acute infectious thyroiditis or acute suppurative 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.
C.1. Diseases associated to Acute thyroiditis
1. Tonsillitis
There is a report of a case of a previously healthy, 28-year-old man who, after being affected by tonsillitis, developed suppurative thyroiditis complicated by thyrotoxicosis; a large abscess in the right lobe of the thyroid extending to the thorax introitus, which caused a trachea deviation and compressed large vessels; associated with internal jugular vein thrombosis, and sepsis(17).
2. Bacterial throat infection
Thyroid abscesses are rare complications of neck infections. There is a report of a case of a teenager who developed increasing neck pain and swelling following treatment for a Streptococcus throat infection. Imaging demonstrated a complex fluid collection in the left thyroid lobe. Ultrasound guided aspiration was performed for diagnostic purposes, yielding purulent fluid that grew multiple bacterial species(18).
3. Thyroid papillary carcinoma
There is a report of a sixty-one-year-old female was admitted to our hospital in October 1988 because of fever and a right neck mass associated with redness and tenderness. The size of the thyroid mass had gradually increased over 3 months. The histologic examination of the resected thyroid revealed the coexistence of encapsulated follicular adenoma, minute papillary carcinoma and chronic thyroiditis. There are few reports of such a case having a combination of suppurative thyroiditis, thyroid cancer and chronic thyroiditis observed in an elderly female(19).
4. Esophageal carcinoma
there is a report of a 68 year old, previously well woman presented with dysphagia, weight loss and a neck swelling. Investigations revealed a right-sided thyroid abscess with fistulous connection to the upper of two oesophageal carcinomas, a previously unreported association(20).
5. Laryngologic problem
There is a report of four cases of acute suppurative thyroiditis treated in our department. Initial symptoms are similar to acute pharyngitis or laryngitis but could end in fulminant course that could be life threatening, according to the Klinika Otolaryngologii CMKP w Warszawie(20a).
6. Graves’ disease and diabetes mellitus
There is a report of a diabetic woman with Graves’ disease in whom thyrotoxicosis occurred after Klebsiella pneumoniae thyroiditis, with relapse nine months after discharge. Thus, the patient’s thyrotoxicosis might not have been caused simply from thyroid tissue destruction by AST, but also as a result of enhancing autoimmune activity. In diabetics, the impairment of chemotaxis and phagocytosis has been noted. Therefore, diabetes mellitus (DM) might have been the precipitating factor for this patient’s acquiring this unusual infection(20b).
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Sources
(17) http://www.ncbi.nlm.nih.gov/pubmed/22990644
(18) http://www.ncbi.nlm.nih.gov/pubmed/22470780
(19) http://www.ncbi.nlm.nih.gov/pubmed/8262271
(20) http://www.ncbi.nlm.nih.gov/pubmed/1437962
(20a) http://www.ncbi.nlm.nih.gov/pubmed/16521464
(21) http://www.ncbi.nlm.nih.gov/pubmed/22990644
(21a) http://www.ncbi.nlm.nih.gov/pubmed/19334391
(20b) http://www.ncbi.nlm.nih.gov/pubmed/9134826