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An autonomous thyroid nodule or "hot nodule" is one that has thyroid function independent of the homeostatic control of the HPT axis (hypothalamic–pituitary–thyroid axis). According to a 1993 article, such nodules need to be treated only if they become toxic; surgical excision (thyroidectomy), radioiodine therapy, or both may be used. [32]
Treatment of a thyroid nodule depends on many things including size of the nodule, age of the patient, the type of thyroid cancer, and whether or not it has spread to other tissues in the body. If the nodule is benign, patients may receive thyroxine therapy to suppress thyroid-stimulating hormone and should be reevaluated in six months. [2]
[4] [5] It can be distinguished from subacute granulomatous thyroiditis by lack of pain, presence of TPO or thyroglobulin (Tg) antibodies, and normal inflammatory markers. [4] [5] Fine needle aspiration (FNA) should be performed in patients who also have a thyroid nodule to rule out thyroid cancer. [5]
The goals of treatment are to lessen hyperthyroid symptoms and relieve discomfort. Pain control only necessitates symptomatic treatment with non-steroidal anti-inflammatory medications or aspirin. [2] Severely sick individuals may benefit from glucocorticoid medication, which often produces a substantial response in 24 to 48 hours. [4]
Medications such as propylthiouracil and methimazole are administered to block the release of thyroxine from the thyroid and to block the damage thyroxine inflicts on muscle fiber tissue. [citation needed] One treatment option is the use of radioactive iodine which directly destroys the overactive thyroid gland.
Occurrences of AIT are most common in patients with prior thyroid disease such as Hashimoto's thyroiditis or thyroid cancer. The most common cause of infection in children is a congenital abnormality such as pyriform sinus fistula. [5] In most cases, the infection originates in the piriform sinus and spreads to the thyroid via the fistula. [7]
Certain medications can have the unintended side effect of affecting thyroid function. While some medications can lead to significant hypothyroidism or hyperthyroidism and those at risk will need to be carefully monitored, some medications may affect thyroid hormone lab tests without causing any symptoms or clinical changes, and may not require treatment.
Treatment of the thyroid disease usually leads to resolution of the paralytic attacks. Depending on the nature of the disease, the treatment may consist of thyrostatics (drugs that reduce production of thyroid hormone), radioiodine , or occasionally thyroid surgery.