thyriodiitti

Thyriodiitti, or thyroiditis, is inflammation of the thyroid gland. It can be acute or chronic and arises from autoimmune processes, infection, or other causes. The clinical presentation ranges from a painful, swollen gland with thyrotoxic symptoms to a subtle or asymptomatic enlargement with eventual changes in thyroid function.

The most common forms are Hashimoto's thyroiditis, an autoimmune disease that often leads to chronic hypothyroidism and gradual thyroid enlargement; subacute granulomatous thyroiditis (De Quervain) which typically presents with a tender, enlarged thyroid and a transient thyrotoxic phase followed by possible hypothyroidism; and painless thyroiditis (silent or autoimmune), which may occur postpartum or in association with other autoimmune conditions and usually resolves or becomes hypothyroid for a period. Rare forms include infectious thyroiditis and Riedel's thyroiditis, a fibrous, hard goiter. Thyroiditis can present with neck pain, fever, fatigue, weight changes, palpitations, or menstrual irregularities, depending on the phase and underlying cause.

Diagnosis relies on thyroid function tests showing changes in TSH and free T4, and sometimes T3. Autoantibodies (such as thyroid peroxidase antibodies) support autoimmune thyroiditis. ESR or CRP levels may be elevated in subacute thyroiditis. Imaging with ultrasound can reveal characteristic glandular patterns, and radioactive iodine uptake is usually low or normal in thyroiditis, helping distinguish it from other causes of hyperthyroidism.

Treatment is type-specific. Painful subacute thyroiditis may require NSAIDs or steroids; beta-blockers can manage hyperthyroid symptoms. Hypothyroidism from thyroiditis is treated with thyroid hormone replacement, and antithyroid drugs are not typically useful. Most forms are self-limited, though autoimmune thyroiditis can cause long-term thyroid dysfunction requiring ongoing management. Regular monitoring of thyroid function is recommended.