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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]
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]
Rarely goiters can cause compression of the airway, compression of the vessels in the neck, or difficulty swallowing. [7] Tumors, often called thyroid nodules, can also have many different symptoms ranging from hyperthyroidism to hypothyroidism to swelling in the neck and compression of the structures in the neck. [7]
The thyroid gland is extremely painful, rigid, and swollen, which can be symmetrical or asymmetrical. [2] Approximately half of affected adolescents and two-thirds of adults have widespread thyroid gland involvement. [3] [5] Thyroid nodules are seen in one-fourth of adult patients. [6] The surrounding skin is occasionally warm and erythematous.
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.
Colloid nodules may be initially identified as an unspecified kind of thyroid nodule. Follow-up examinations typically include an ultrasound if it is unclear whether or not there really is a nodule present. Once the presence of a nodule has been confirmed, the determination of the kind of thyroid nodule is done by fine needle aspiration biopsy. [7]
A cold nodule is a thyroid nodule that does not produce thyroid hormone. [1] On a radioactive iodine uptake test a cold nodule takes up less radioactive material than the surrounding thyroid tissue. [1] A cold nodule may be malignant or benign. [1] On scintigraphy cold nodules do not show but are easily shown on ultrasound. [2]
The diagnosis of subacute thyroiditis can be made clinically by eliciting risk factors, associated symptoms, and physical examination. [1] [2] [3] Further work-up to differentiate between the etiologies of subacute thyroiditis can include: thyroid function tests (TFTs), inflammatory markers, complete blood count (CBC), and thyroid antibodies.
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