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It has been shown that the prevalence of positive tests for thyroid antibodies increases with age, "with a frequency as high as 33 percent in women 70 years old or older." [ 27 ] Hashimoto's thyroiditis can occur at any age, including children, [ 119 ] but more commonly appears in middle age , particularly for men. [ 123 ]
Thyroiditis is generally caused by an immune system attack on the thyroid, resulting in inflammation and damage to the thyroid cells. This disease is often considered a malfunction of the immune system and can be associated with IgG4-related systemic disease, in which symptoms of autoimmune pancreatitis, retroperitoneal fibrosis and noninfectious aortitis also occur.
Postpartum thyroiditis can recur in subsequent pregnancies. [2] [4] [5] Drug-induced thyroiditis can occur in individuals receiving certain therapies such as amiodarone, interferon-alpha, lithium, tyrosine-kinase inhibitors, and immunotherapies among other drugs. These individuals may develop subacute lymphocytic thyroiditis. [2] [3] [4] [5]
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Though it only happens in 5–15% of cases, persistent hypothyroidism can develop years after the diagnosis. [6] [28] Recurrent de Quervain thyroiditis is rare, occurring in about 2% of cases, and usually manifests again within a year after diagnosis. But there have also been reports of late recurrences after several years.
The accuracy of the diagnosis depends on obtaining tissue from all of the suspicious areas of an abnormal thyroid gland. The reliability of fine needle aspiration is increased when sampling can be guided by ultrasound, and over the last 15 years, this has become the preferred method for thyroid biopsy in North America. [32] [citation needed]
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Acute infectious thyroiditis (AIT) also known as suppurative thyroiditis, microbial inflammatory thyroiditis, pyrogenic thyroiditis and bacterial thyroiditis. [ 1 ] [ 2 ] [ 3 ] The thyroid is normally very resistant to infection.