How to check for thyroiditis?

Written by Li Hui Zhi
Endocrinology
Updated on September 22, 2024
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Thyroiditis is a general term. Clinically, the most common type is subacute thyroiditis, and another is Hashimoto's thyroiditis, which are two different diseases. For subacute thyroiditis, the symptoms include fever, neck pain, and throat discomfort. Generally, the first step is to check thyroid function to see if there is hyperthyroidism or hypothyroidism. The second step is to suggest antibody tests, including anti-thyroid peroxidase antibodies and anti-thyroglobulin antibodies. The third suggestion is to conduct a routine blood test and erythrocyte sedimentation rate. Fourth, a thyroid ultrasound is recommended. If necessary, a thyroid fine-needle aspiration may be performed for a definitive diagnosis. If it's Hashimoto's thyroiditis, which is an autoimmune disease, a specific antibody, TPOAB or anti-thyroid peroxidase antibody, is used for diagnosis.

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Causes of Acute Thyroiditis

We generally refer to acute thyroiditis as an acute suppurative thyroiditis, which is a type of purulent infectious disease, often caused by a mixed bacterial infection, such as staphylococcus, streptococcus, gram-negative bacilli, and anaerobes, etc. Patients with compromised or deficient immune functions, such as those with AIDS, leukemia, diabetes, can also have infections like fungi and pneumocystis. Some thyroid nodules, due to events like necrosis or cystic changes from punctures, can also cause a suppurative infection, and this condition is generally common among middle-aged and elderly patients. Therefore, the main cause of acute thyroiditis is mostly due to infections.

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Causes of thyroiditis

The causes of thyroiditis are mainly divided into several types: The first type is acute thyroiditis, which is mostly caused by bacterial infection. Some abscesses in the thyroid lead to fever and inflammation of the thyroid. Generally, anti-infection treatment can achieve a curative effect. The second type, subacute thyroiditis, is mostly caused by viral infections. It is a self-limiting disease that can be cured by using some analgesics, and even some hormonal medications. Chronic thyroiditis generally arises from autoimmune diseases. Often in the late stages, it causes reduced thyroid function. Since currently there are no drugs to intervene in autoimmune diseases, the main treatment is medication maintenance and control of thyroid function within the normal range. Therefore, the causes of thyroiditis need to be divided into acute, subacute, and chronic thyroiditis to distinguish its causes. (The use of medication should be done under the guidance of a professional doctor.)

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Is thyroiditis fever dangerous?

Fever symptoms in thyroiditis mainly refer to acute suppurative thyroiditis and subacute thyroiditis. Acute suppurative thyroiditis is a purulent infectious disease, often a mixed bacterial infection, commonly occurring after upper respiratory infections or fine-needle aspiration of thyroid nodules. Symptoms can include thyroid enlargement, pain, difficulty swallowing, fever, and other systemic symptoms. Broad-spectrum antibiotics can be used for initial treatment. If the pathogen is identified, the type of antibiotic can be adjusted. Some patients may require incision and drainage if an abscess is present, and in very rare cases, complications such as tracheal obstruction or mediastinitis may occur. Additionally, patients with subacute thyroiditis may also experience fever, usually a mild to moderate increase in body temperature, and in some cases, it can reach 40°C. The fever typically peaks around the third to fourth day and subsides in about a week. Patients with this type of fever can generally use non-steroidal anti-inflammatory drugs, and since subacute thyroiditis is a self-limiting disease, whether the fever in thyroiditis is dangerous depends on the situation.

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Does thyroiditis hurt?

The most common causes of thyroiditis refer to subacute thyroiditis and autoimmune thyroiditis. Subacute thyroiditis is mainly caused by viral infection, leading to the destruction of thyroid follicular cells. This generally results in pain in the thyroid region, which can even radiate to areas like the back of the neck and ears, with the pain symptoms being relatively significant. Meanwhile, Hashimoto's thyroiditis typically does not present with pain, although a small number of patients may experience localized pain during the onset of the disease, but the symptoms are usually mild. Additionally, the pain in the neck thyroid region associated with subacute thyroiditis varies from person to person, with varying degrees of pain intensity. It is primarily treatable with steroids or non-steroidal anti-inflammatory drugs, and generally, the symptoms can be relieved after treatment.

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There are several types of thyroiditis.

Thyroiditis primarily includes acute, subacute, and chronic forms. Acute and subacute thyroiditis are generally seen in bacterial and viral infections, while chronic thyroiditis mainly consists of autoimmune thyroiditis, painless thyroiditis, and postpartum thyroiditis. However, autoimmune thyroiditis itself encompasses five scenarios, including Hashimoto's thyroiditis, atrophic thyroiditis, painless thyroiditis, euthyroid thyroiditis, and Hashitoxicosis. These types of thyroiditis are mainly seen in chronic thyroid conditions and are all autoimmune diseases. Therefore, the type of thyroiditis should be determined based on the cause to develop appropriate treatment plans.