tireoidites

Thyroiditis, or tireoidites in some languages, is an umbrella term for inflammation of the thyroid gland. It encompasses several distinct clinical entities that vary in cause, course, and treatment. The condition ranges from acute bacterial thyroiditis to chronic autoimmune forms and rarer fibrous or drug-induced variants.

Common forms include acute thyroiditis, usually due to bacterial infection, presenting with fever, neck tenderness, and sometimes an abscess. Subacute thyroiditis (granulomatous or De Quervain) often follows a viral illness and presents with a painful, tender thyroid and transient thyrotoxicosis, followed by hypothyroidism in some cases. Autoimmune forms include Hashimoto thyroiditis, a chronic, often painless process that leads to progressive thyroid failure and hypothyroidism, frequently associated with thyroid autoantibodies such as anti-TPO. Silent (painless) thyroiditis and postpartum thyroiditis are autoimmune-related, typically presenting with an initial thyrotoxic phase that may transition to hypothyroidism and usually resolve over time. Riedel’s thyroiditis is a rare form characterized by fibrous replacement of the gland and sometimes compressive symptoms. Drug-induced thyroiditis can occur with medications such as amiodarone or immune-modulating therapies, and radiation therapy can also trigger thyroid inflammatory changes.

Diagnosis is based on clinical presentation, thyroid function tests (TSH, free T4, sometimes free T3), and antibody testing. Imaging, especially ultrasound, and radioactive iodine uptake studies help differentiate thyroiditis from other thyroid diseases. Fine-needle aspiration may be used when infection or malignancy is suspected.

Treatment depends on the form and phase. Acute bacterial thyroiditis requires antibiotics and may need drainage. Subacute thyroiditis is often managed with NSAIDs or corticosteroids; thyrotoxic symptoms can be treated with beta-blockers. Hypothyroidism is treated with levothyroxine as needed. Most forms are self-limited, though Hashimoto and some other types may require long-term management.