resting lymphocytic thyroiditis
Introduction
Introduction to resting lymphocytic thyroiditis Subacute lesions occur mostly in women in the postpartum period. Most of the diseases occur in postpartum thyroid dysfunction. The incidence of postpartum women is about 5% to 10%. Although the cause of static thyroiditis is unclear, recent evidence suggests that it is an autoimmune disease. The development of resting lymphocytic thyroiditis is slow and the disease can be asymptomatic in the early stage. When the goiter is present, the course of disease has reached 2 to 4 years on average. basic knowledge Sickness ratio: 0.05% Susceptible population: most occur in women in the postpartum period Mode of infection: non-infectious Complications: hypothyroidism
Cause
Cause of resting lymphocytic thyroiditis
Cause of disease:
The cause is unclear, but recent evidence suggests an autoimmune disease.
Static thyroiditis is often not diagnosed because hyperthyroidism can be transient, mild or not at all.
Biopsy revealed lymphocytic infiltration like Hashimoto's thyroiditis, but no lymphoid follicles and scars. Thyroid peroxidase antibodies and rare anti-thyroglobulin antibodies are almost always positive during pregnancy and postpartum, so the disease is a variant of Hashimoto's thyroiditis. Serum T3, T4 levels in quiescent lymphocytic thyroiditis, TSH inhibition with very low radioactive iodine absorption, these laboratory tests similar to subacute thyroiditis, artificial hyperthyroidism and iodine-induced hyperthyroidism. White blood cell count and erythrocyte sedimentation rate are normal. No eye signs and sputum mucinous edema.
Prevention
Static lymphocytic thyroiditis prevention
Excessive intake of iodine in patients with thyroiditis can cause hypothyroidism and mucinous edema. For example, after eating iodine-rich foods such as kelp and seaweed, isotope examination cannot be performed within 2 months, otherwise the accuracy of the examination will be affected. It is true that patients with goiter should first go to the hospital for examination and diagnosis, and take medication or diet treatment under the guidance of a doctor. Do not blindly eat iodine or foods rich in iodine.
Complication
Symptoms of resting lymphocytic thyroiditis Complications hypothyroidism
Can be complicated by transient hyperthyroidism, and occasionally permanent hypothyroidism.
Symptom
Static lymphocytic thyroid symptoms common symptoms thyroid gland and smooth... goiter goiter edema
Static thyroiditis is often not diagnosed because hyperthyroidism can be transient, mild or not at all.
Biopsy revealed lymphocytic infiltration like Hashimoto's thyroiditis, but no lymphoid follicles and scars. Thyroid peroxidase antibodies and rare anti-thyroglobulin antibodies are almost always positive during pregnancy and postpartum, so the disease is a variant of Hashimoto's thyroiditis. Serum T3, T4 levels in quiescent lymphocytic thyroiditis, TSH inhibition with very low radioactive iodine absorption, these laboratory tests similar to subacute thyroiditis, artificial hyperthyroidism and iodine-induced hyperthyroidism. White blood cell count and erythrocyte sedimentation rate are normal. No eye signs and sputum mucinous edema.
Examine
Examination of resting lymphocytic thyroiditis
1, serum thyroid microsomal antibody (TMAb) and thyroid white antibody (TGAb) positive, and most of them are high titers, such as 2 times 60%, even if the symptoms are not typical can be diagnosed.
2, thyroid biopsy: fine needle acupuncture see a large number of lymphocytes, plasma cells, may have eosinophilic sputum cells appear.
3, the results of thyroid function test depends on the disease stage, a small number of patients in the early stage of onset can have a hyperthyroidism performance, blood T3, T4, FT3, FT4 can be increased, most patients with early thyroid function can be completely normal, after T3, T4 is normal, but thyroid stimulating hormone (TSH) is elevated, or thyroid stimulating hormone releasing hormone (TRH) stimulation test TSH is highly reactive, at this time thyroid iodine 131 uptake rate can also be increased, but can be T3 inhibition test This inhibition can be distinguished from Graves' disease. When hypothyroidism occurs in the late stage of the disease, FT4, T4, FT3, T3 decrease, TSH increases, and thyroid iodine 131 uptake rate decreases.
Diagnosis
Diagnosis and diagnosis of resting lymphocytic thyroiditis
diagnosis
Diagnosis can be based on medical history, clinical symptoms, and laboratory tests.
Differential diagnosis
1. Subacute thyroiditis: caused by a virus. There is often a history of viral upper respiratory tract infection. Histological examination shows that thyroid lymphocyte infiltration is lighter than Hashimoto's thyroiditis and resting thyroiditis, but there are characteristic giant cell infiltration, more The nucleated white blood cells and follicles rupture.
2. Hashimoto's thyroiditis: Chronic thyroid inflammation caused by infiltration of glandular lymphocytes by autoimmune factors. Histological studies have found extensive lymphocyte infiltration of the thyroid with lymphoid follicles.
