Silent thyroiditis
| Classification according to ICD-10 | |
|---|---|
| E06.3 | Autoimmune thyroiditis |
| ICD-10 online (WHO version 2019) | |
The silent thyroiditis , also the common term is silent thyroiditis , is an inflammation of the thyroid gland (thyroiditis) . Women and people in iodine-deficient areas have an increased risk of disease.
On the basis of the histological picture, it is also assigned to the subacute lymphocytic thyroiditis and, due to the detection of TPO antibodies, also to the autoimmune thyroiditis in around 50 percent of those affected .
Clinical picture
Clinically, the disease is characterized by a two-phase course. Each phase usually only lasts a few weeks. First, the immigration of lymphocytes ( infiltration ) and the associated destruction ( destruction ) of thyroid tissue with the release of thyroid hormones lead to an overactive thyroid (hyperthyroidism) . Then, after consumption of the thyroid hormones, a phase follows the thyroid (hypothyroidism) . The symptoms are determined by the thyroid dysfunction existing in the respective phases, but are rather mild compared to other thyroid inflammations. There is no pain.
Diagnosis, therapy and course
The diagnosis is based on the clinical picture, laboratory diagnostics (determination of thyroid hormones, thyroid antibodies), and the ultrasound findings. If there are any doubts about the diagnosis, a thyroid scintigraphy and sampling by fine needle aspiration with a subsequent histological examination can be used for differential diagnosis .
The disease is self-limiting and usually heals without consequences. Treatment is symptomatic. Thyreostatics are not used because there is no overproduction of thyroid hormones, but only a temporary increased release.
Demarcation
Silent thyroiditis must be differentiated from other lymphocytic thyroiditis with a similar course. These are in particular chronic lymphocytic thyroiditis (better known under the name Hashimoto's thyroiditis ) and another subacute lymphocytic thyroiditis , postpartum thyroiditis . The latter can occur after pregnancy. The subacute thyroiditis de Quervain is typically associated with a phase of hyperthyroidism and a phase of hypothyroidism, but is characterized by pain.
Individual evidence
- ^ A. Bindra, GD Braunstein: Thyroiditis. In: American family physician. Volume 73, Number 10, May 2006, ISSN 0002-838X , p. 1774, PMID 16734054 .
- ↑ a b c H. Mönig, B. Harbeck: Thyreoiditis. In: DMW - German Medical Weekly . 133, 2008, doi : 10.1055 / s-2008-1046710 , p. 303.
