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[Thyroiditis: What's new in 2019?]

A Rouland1, P Buffier2, J-M Petit1

  • 1Service d'endocrinologie, diabétologie, maladies métaboliques, CHU de Dijon, 2, boulevard Maréchal-de-Lattre-de-Tassigny, 21000 Dijon, France; Unité Inserm LNC-UMR 1231, université de Bourgogne-Franche-Comté, Dijon, France.

La Revue De Medecine Interne
|February 29, 2020
PubMed
Summary
This summary is machine-generated.

Thyroiditis, a common thyroid imbalance, requires accurate diagnosis and etiology determination for effective patient management. Treatment varies based on the type of thyroiditis, ranging from antibiotics to hormone replacement therapy.

Keywords:
HyperthyroidismHyperthyroïdieHypothyroidismHypothyroïdieImmunotherapyImmunothérapieIodeIodineThyroiditisThyroïdite

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Area of Science:

  • Endocrinology
  • Internal Medicine

Background:

  • Thyroiditis encompasses a spectrum of thyroid gland inflammatory conditions, frequently benign but capable of disrupting thyroid hormone balance.
  • Accurate diagnosis and etiological understanding are crucial for effective patient management.

Observation:

  • Painful thyroiditis presents as acute infectious thyroiditis (treated with antimicrobials) or subacute thyroiditis (managed with anti-inflammatory drugs or corticosteroids).
  • Hashimoto's thyroiditis causing overt hypothyroidism necessitates L-thyroxine replacement therapy, adjusted based on Thyroid Stimulating Hormone (TSH) levels.
  • Medications like amiodarone and immunotherapies (anti-PD-1/PDL1, anti-CTLA-4) can induce dysthyroidism, requiring regular thyroid monitoring even without overt symptoms.

Findings:

  • Hypothyroidism is managed with thyroid replacement therapy, guided by TSH levels and anti-thyroid peroxidase (anti-TPO) antibodies.
  • Hyperthyroidism management may involve amiodarone cessation, beta-blockers, or antithyroid drugs, particularly if anti-TSH receptor antibodies are present.

Implications:

  • Prompt diagnosis and tailored treatment strategies are essential for managing diverse thyroiditis presentations.
  • Close monitoring of thyroid function is vital for patients on medications known to affect thyroid status.
  • Consultation with an endocrinologist is recommended for accurate diagnosis confirmation and optimal treatment planning.