[Thyroiditis]

The most common form of thyroiditis is undoubtedly chronic lymphocytic thyroiditis (Hashimoto's thyroiditis). It presents in the form of a small insignificant struma without any signs of inflammation, which is easily overlooked in our region (where once goiters due to iodine-deficiency have been common). Therapy is only indicated when the patient is disturbed by the size of the goiter or when he is hypothyroid. The disease can be easily diagnosed by palpation and investigation of autoantibodies. Repeated antibody-tests are not necessary, however, it is useful to measure TSH every two years since some of the patients develop hypothyroidism. In contrast to the relatively mild findings in Hashimoto's thyroiditis the subacute granulomatous thyroiditis (de Quervain) presents with an impressive clinical picture with pain, fever, malaise and elevated blood sedimentation rate, that may alarm the patient as well as the unexperienced physician. Treatment with prednisone is extremely effective and leads to complete remission.