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Thyroid disease is a medical condition that affects the structure and/or function of the thyroid gland. The thyroid gland is located at the front of the neck and produces thyroid hormones [ 1 ] that travel through the blood to help regulate many other organs, meaning that it is an endocrine organ .
Hashimoto's thyroiditis, also known as chronic lymphocytic thyroiditis, Hashimoto's disease and autoimmune thyroiditis, is an autoimmune disease in which the thyroid gland is gradually destroyed. [7] [1] Early on, symptoms may not be noticed. [3] Over time, the thyroid may enlarge, forming a painless goiter. [3]
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]
Thyroid hormone treatment is also included if required. Failure of some patients to respond to this first-line treatment has produced a variety of alternative treatments, including azathioprine , cyclophosphamide , chloroquine , methotrexate , periodic intravenous immunoglobulin, and plasma exchange.
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.
Thyroid function testing often shows decreased thyroid stimulating hormone and increased serum levels of triiodothyronine and thyroxine during the acute phase. Thyroid scans show minimal uptake during the acute phase due to disrupted thyroid follicles, but increase during recovery due to the thyroid gland's enhanced iodine trapping capacity.
After long-term heavy strain, levels of thyroid hormones decrease. [2] This is exacerbated by other stressors such as undernutrition and lack of sleep, such as in a military training setting. During endurance exercise, before exhaustion, elevated thyroid hormone levels may happen due to increased expected energy demand (type 2 allostatic load). [2]
[7] [8] In 1926 the Japanese physician Tetsushiro Shinosaki, from Fukuoka, observed the high rate of thyroid disease in Japanese people with periodic paralysis. [ 9 ] [ 10 ] The first English-language report, in 1931, originated from Dunlap and Kepler, physicians at the Mayo Clinic ; they described the condition in a patient with features of ...