Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content + • Autoimmune thyroiditis• Possible initial transient hyperthyroidism• Possible chronic hypothyroidism +++ Epidemiology + • Most common form of thyroiditis• 0.3 to 1.5 cases per 1000 population per year; 10-15 times more common in women• Approximately 15% of women are affected in the United States; majority are 30-50 years of age +++ Symptoms and Signs + • Enlarged, occasionally tender, thyroid• Atrophic stage, shrunken, firm thyroid• Dysphagia +++ Laboratory Findings + • Elevated thyroid-stimulating hormone (TSH)• Decreased tri-iodothyronine (T3) and thyroxine (T4 ) levels• Elevated titers of antimicrosomal and antithyroglobulin antibodies + • Patient may have other associated autoimmune conditions• Associated with HLA-DR3, HLA-DR5, and HLA-B8• Thyroid neoplasia should be ruled out in the setting of asymmetry or cervical lymphadenopathy +++ Rule Out + • Thyroid lymphoma• Thyroid carcinoma + • History and physical exam• Serum thyroid function tests and thyroglobulin and microsomal antibody titers• Needle biopsy if concerned about malignancy + • Initial treatment includes administration of exogenous thyroid hormone +++ Surgery +++ Indications + • Local symptoms of pressure• Suspected malignancy• Enlarging gland despite a trial of thyroid hormone suppression +++ Medications + • Thyroid hormone• Occasionally, a β-blocker is required to control symptoms of hyperthyroidism +++ Treatment Monitoring + • TSH, T3, and T4 levels +++ Complications + • Association with thyroid lymphoma +++ References ++Kon YC, DeGroot LJ: Painful Hashimotoâs thyroiditis as an indication for thyroidectomy: clinical characteristics and outcome in seven patients. J Clin Endocrinol Metab 2003;88:2667. [PubMed: 12788871] ++Mezosi E et al: Aberrant apoptosis in thyroid epithelial cells from goiter nodules. J Clin Endocrinol Metab 2002;87:4264. [PubMed: 12213883] Your Access profile is currently affiliated with [InstitutionA] and is in the process of switching affiliations to [InstitutionB]. Please select how you would like to proceed. Keep the current affiliation with [InstitutionA] and continue with the Access profile sign in process Switch affiliation to [InstitutionB] and continue with the Access profile sign in process Get Free Access Through Your Institution Learn how to see if your library subscribes to McGraw Hill Medical products. Subscribe: Institutional or Individual Sign In Error: Incorrect UserName or Password Username Error: Please enter User Name Password Error: Please enter Password Sign in Forgot Password? Forgot Username? Download the Access App: iOS | Android Sign in via OpenAthens Sign in via Shibboleth You already have access! Please proceed to your institution's subscription. Create a free profile for additional features.