Examination of subacute thyroiditis, key points for diagnosing subacute thyroiditis

For subacute thyroiditis, blood should be drawn for erythrocyte sedimentation rate, complete blood count, serum total T3, total T4, free T3, free T4, TSH, thyroglobulin antibody (TRAB), thyroid peroxidase antibody (TPO), thyroid ultrasound, thyroid iodine uptake rate test, and thyroid nuclide scan. White blood cell count and neutrophils are normal or high, erythrocyte sedimentation rate is increased at 50 mm hour, serum protein-bound iodine or serum T3, T4, FT3 and FT4 concentrations are increased, thyroid iodine uptake rate is reduced, thyroid gland enlargement can be seen on thyroid scan, but the image is uneven or mutilated, and some are not visible at all. Protein electrophoresis shows a decrease in albumin and an increase in globulin, mainly in R and 1 globulins.

Subacute thyroiditis, which is self-limited, is the most common painful thyroid disease and is more common in middle-aged women between the ages of 30 and 50. The typical manifestation is severe thyroid pain, usually the pain begins on one side of the thyroid gland, and soon radiates to other parts of the gland and the root of the ear and jaw, often accompanied by general malaise, movement, muscle pain, and fever, reaching a peak within 3 or 4 days after illness, subsiding within 1 week, there are also many patients with slow onset, more than 1 2 weeks, the ups and downs of the condition continue for 3 6 weeks, after improvement, there can be many times in a few months**, the thyroid gland can be larger than the normal volume of 2 3 times or larger, and the tenderness is obvious when contacted.

Examinations: blood routine examination, biochemical examination, thyroid ultrasound examination, serum T4 and T3 detection, thyroid autoantibody examination, etc.

Key points of diagnosis].

1.History of upper respiratory tract infection prior to onset, acute onset, fatigue and malaise, fever, pain in the thyroid gland and pharynx, worsening when turning the head or swallowing, or radiating to the ear, jaw or occipital. About half of patients may have mild symptoms of hyperthyroidism at the beginning of the disease, which usually lasts no more than 2 weeks.

mildly enlarged, hard thyroid with nodules, marked tenderness, located on one side, may extend to the other; It can also disappear on one side and then reappear on the other. Resolves spontaneously after a few weeks, but**.

2.Laboratory tests: in the early stages, erythrocyte sedimentation rate is often markedly increased, and white blood cells are normal or reduced.

Blood T3, T4, FT3, and FT4 are increased, and blood thyroid-stimulating hormone (TSH) is decreased, and thyroid iodine-131 uptake rate is significantly reduced, which is of great significance for the diagnosis of this disease. Later, T3, T4, FT3, and FT4 may be reduced, and thyroid-stimulating hormone (TSH) may be elevated. As the condition improves, thyroid iodine uptake and serum thyroid hormones normalize.

3.Thyroid biopsy: fine needle aspiration smear shows multinucleated giant cells, epithelial cells, and fibroblasts.

Prednisone has obvious efficacy, 5 mg each time, 4 times a day, for two weeks, and then gradually reduce the dose. To avoid**, it can be extended up to six weeks. In cases where goiter pain is particularly pronounced, thyroxine can sometimes be substituted**, and 30 mg of dry thyroid tablets taken orally every day usually works.

I also have subacute thyroiditis, at first I had a sore throat and neck tenderness, I went to the hospital for a B ultrasound, the doctor said it was methyleneitis, let me test whether the thyroid function is abnormal (blood test), I did not do it because of blood sickness.

The doctor prescribed me Banlangen and compound chlorzoxazone tablets for a week, saying that I should remove the virus first in the early stage and let me retest it in a week.

After eating for a week, the (small) lump on the side of the neck became significantly smaller, (yesterday) the doctor said that he would continue to take the above medicine for a week, plus amoxicillin clavulanate potassium tablets (3 days' supply), saying that this time it was to prevent bacterial infection, and asked me to go to the hospital for thyroid function test in a week.

I am now taking the second phase of medicine, I hope it has a good effect The above is my medical process, for your reference, and I wish you a good day

I was also before methyleneitis, I had a high fever at the beginning, and I was often misdiagnosed as a respiratory disease.

Chapter 17 Endocrine System 11 Subacute Thyroiditis: Clinical Manifestations, 3 Stage Examination Indicators, **Drugs.

The cause of subacute thyroiditis is not particularly clear, it may be related to viral infection, and in general, there will be a history of upper respiratory tract infection before the onset of the disease, and this disease is the peak season in summer, and it is more common in middle-aged women. Patients will experience fever, swollen lymph nodes in the neck, pain in the thyroid gland. The prognosis of this disease is very good, there are no sequelae, and drugs can generally be taken to treat the symptoms**.

According to the thyroid test report you provided, it is a condition of thyroiditis with hypothyroidism; Ultrasound shows an enlarged thyroid gland that your neck is swollen.

Hashimoto's thyroiditis with hypothyroidism should be aggressive**.

Subacute thyroiditis, also known as granulomatous, giant cell or de quatrain thyroiditis, is related to viral infection, often with a history of upper respiratory tract infection before the onset, and viral antibodies can be detected in the blood of patients, the most common is coxsackievirus, followed by adenovirus antibodies, influenza viruses and mumps virus antibodies. It is more common in women between the ages of 20 and 50, and the incidence in women is more than 4 times higher than in men.

**: This disease is often secondary to epidemic and viral mumps, so it is generally thought that the disease may be a viral infection. Infection destroys thyroid follicles, releasing colloids that cause a foreign body-like reaction in thyroid tissue.

Leukocyte infiltrates and many giant cells engulfed with colloidal granules may be seen on tissue sections. It can be withered by traditional Chinese medicine.

At present, it is believed that the disease is mostly related to viral infection, and there is a history of upper respiratory tract infection before the onset of the disease, or a history of respiratory tract infection or mumps in the history of cold, etc., and patients may often have symptoms such as fever, sore throat, fatigue and muscle aches. Generally, it can be combined with traditional Chinese and Western medicine**.

Analysis: Hello; The condition you describe is caused by yin deficiency and internal heat, but diabetes needs to be ruled out. Guidance:

You can use Shengmai Oral Liquid, Liuwei Dihuang Pill Concentrate Pill to**. You can also use American ginseng, wheat winter, scutellaria, lily, and jujube to replace tea. Don't eat raw, cold, spicy food.

Maintain a good mood.

Thyroiditis is generally divided into subacute thyroiditis, and Hashimoto's thyroiditis, etc., generally methylene inflammation is mainly neck pain and discomfort, general color ultrasound, erythrocyte sedimentation rate, and thyroglobulin antibodies, anti-thyroglobulin, etc.

Tests may be done for acute suppurative thyroiditis.

1.Peripheral white blood cell count and neutrophils are elevated in a complete blood count.

2.Erythrocyte sedimentation rate is accelerated.

Reactive protein is elevated.

4.thyroid function tests; Most patients with bacterial AST have normal thyroid function, but in fungal cases, thyroid function is mostly low, while patients with mycobacterial infection tend to have hyperthyroidism.

5.bacteriological examination; A neck puncture aspirates pus for bacterial culture, and a Gram stain helps identify the infecting bacteria.

6.Thyroid scan; Cool nodules or cold nodules can be found in more than 90% of patients with bacterial infections and 78% of patients with mycobacterial infections.

Ultrapedography may reveal swelling or abscess formation in a single lobe of the thyroid gland.

line inspection; Deviation or compression of the trachea may be detected, and sometimes free gases produced by gas-producing bacteria in the thyroid gland and the tissues surrounding the thyroid gland may be detected.

or MRI may reveal a mediastinal abscess.

from the Department of Thyroid Medicine, Tongji Hospital, Hangzhou).

If you suffer from this disease, you must be in time.