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Thyroiditis - Is an inflammatory process that occurs in thyroid . This disease has a number of different forms that have different etiology and pathogenesis, but the inflammation is an essential component of every disease.
However, certain similarities in symptoms of this group of diseases, in some cases, creates a number of difficulties in the differential diagnosis.
Autoimmune thyroiditis
Chronic autoimmune thyroiditis (another name - lymphomatoid thyroiditis ) Is an inflammatory disease of the thyroid gland, which has an autoimmune nature. In the process of this disease in humans is formed antibodies and lymphocytes That damage its own thyroid cells. At the same time, normal development of antibodies in the body is to foreign substances.
Typically, the symptoms of autoimmune thyroiditis occur in people aged 40 to 50 years, with about ten times more women suffer from this disease. However, in recent years, it recorded more cases of autoimmune thyroiditis in young people and children.
Causes of autoimmune thyroiditis
Nature autoimmune thyroiditis lymphomatous is hereditary. According to research, in close relatives of patients with autoimmune thyroiditis, very often diagnosed diabetes And various diseases of the thyroid gland. However, in order to become a hereditary factor determining the necessary impact and other negative moments. This may be respiratory viral diseases, chronic foci of infection in sinus, tonsils and teeth in which overwhelmed caries .
In addition, contribute to the development of this disease can be long-term treatment with drugs that contain iodine , The effect of radiation. When the body affects one of said triggering moments increases the activity of lymphocytes clones. Accordingly, it begins to produce antibodies to their cages. As a result, these processes lead to a damage thyrocyte - Cells of the thyroid gland. Further, the patient's blood from damaged cells misses all thyroid follicular contents. It stimulates the further appearance of antibodies to the cells of the thyroid gland, and the whole process further is cyclic.
Symptoms of autoimmune thyroiditis
It often happens that for chronic autoimmune thyroiditis occurs without obvious clinical manifestations. However, as the first signs of the disease, patients may observe the appearance of unpleasant sensations in the area of the thyroid gland. The person feels a sense of swallowing a lump in my throat, as well as a certain pressure in the throat. In some cases, the symptoms of autoimmune thyroiditis manifested not very severe pain near the thyroid gland, sometimes they felt only during her probing. Also, the person feels a little weak, unpleasant pain in the joints.
Sometimes due to excessive volume released into the blood hormones that occurs due to damage to the thyroid cells, the patient may appear hyperthyroidism . In this case, patients complain of a number of symptoms. A person may tremble fingers, the heart rate quickens, there is increased sweating, increased arterial pressure . The most commonly manifested hyperthyroidism at the beginning of the disease. Further, the thyroid gland may function normally or its function is partially reduced (shown hypothyroidism ). The degree of hypothyroidism is enhanced under the influence of unfavorable conditions.
Depending on the size of the thyroid gland and the patient's overall clinical picture of autoimmune thyroiditis usually divided into two forms. With atrophic form of autoimmune thyroiditis thyroid gland is not increased. The manifestations of this form of the disease is most commonly diagnosed in elderly patients and young people exposed to radiation. Typically, for this type of thyroiditis is characterized by decreased thyroid function.
With hypertrophic form of autoimmune thyroiditis, by contrast, thyroid enlargement is always observed. The increase in the cancer can occur uniformly throughout the volume (in this case we have diffuse hypertrophic form), or a thyroid appear nodes (holds nodal form). In some cases, nodular and diffuse form of the disease combined. In hypertrophic form of autoimmune thyroiditis possible manifestation tirotoksikoza in the initial stage of disease, however, generally has a special place of normal thyroid function.
Other forms of thyroiditis
Subacute thyroiditis called thyroid disease virus type, which is accompanied by the process of destruction of the thyroid cells. As a rule, subacute thyroiditis manifested about two weeks after a person ill with acute respiratory viral infection. This can be flu . mumps . measles and other ailments. It is also assumed that the cause of subacute thyroiditis can become a pathogen of cat scratch disease.
Typically, subacute thyroiditis manifested a number of common symptoms. A person may have a headache, he feels a general malaise, fatigue, muscle aches, and weakness. Can increase the temperature, chills occur. Amidst all the symptoms the patient significantly reduced performance. However, all these symptoms - non-specific, so they can be observed by any infectious nature of the disease.
In subacute thyroiditis manifested as some of the symptoms of a local nature, is directly related to the defeat of the thyroid gland. There gland inflammation, edema and stretching of the capsules. The patient complains of intense pain in the prostate, which become even stronger in the process of feeling. Often, even the slightest touch to the skin in the area of cancer brings a person very uncomfortable. Sometimes the pain of giving up, extending to the ear, jaw, and sometimes - in the head. During the inspection, the expert usually marks the high sensitivity of the thyroid gland, the presence of weak signs of hyperthyroidism.
Quite often today occurs asymptomatic thyroiditis That is so called because of the lack of patient symptoms of inflammation of the thyroid gland.
To date not set exactly the reasons that lead to the appearance of a person asymptomatic thyroiditis. But thanks to research found that the leading role in the manifestation of the autoimmune disease plays a factor. In addition, according to statistics, the disease is often seen in women who are in the postpartum period.
For this disease is characterized by a slight increase in thyroid cancer. Soreness is absent in this case occurs spontaneously passing phase of hyperthyroidism, which may last several weeks or months. Often then the patient is transient hypothyroidism, in which later restored euthyroid status.
Signs of asymptomatic thyroiditis much similar to the symptoms of autoimmune thyroiditis. The exception in this case is only the fact that, as a rule, the iron recovered, and thyroid hormone replacement therapy lasts a relatively short time - several weeks. But at the same time are frequent relapses.
Diagnosis thyroiditis
In the diagnosis of autoimmune thyroiditis specialist in first drew attention to the study of history and characteristic clinical picture. The diagnosis "autoimmune thyroiditis" easily confirmed finding in the study of blood high levels of antibodies against the proteins affecting the thyroid gland.
In laboratory analyzes of blood there is also an increase in the number of lymphocytes with an overall decrease in the number of leukocytes . When the patient is the stage of hyperthyroidism in the blood is an increase in thyroid hormone levels. When gland function is reduced, there is less blood hormones, but this increases the level of the hormone pituitary thyrotropin . In the process of diagnosis and pay attention for changes in the immunological. Also, an expert assigns an ultrasound, which can be found in the thyroid enlargement, and in the case of nodular thyroiditis - its unevenness. Additionally appointed behavior Biopsy In which the cells are distinguished characteristic of autoimmune diseases lymphomatous thyroiditis.
Subacute thyroiditis is important to differentiate acute pharyngitis . suppurative thyroiditis . infected cyst neck . thyrotoxicosis . thyroid cancer . hemorrhage in nodular goiter . autoimmune thyroiditis and local lymphadenitis .
Treatment thyroiditis
Treatment of autoimmune thyroiditis carried by drug therapy. However, until now there is no specific treatment methods for this disease. Also, it does not develop methods, effective impact on the autoimmune process and prevent progress to autoimmune thyroiditis hypothyroidism. If the thyroid gland is increased, the physician assigns tirostatikov ( Mercazolilum . tiamazol ), and beta-blockers . With NSAIDs reduced antibody production. In this case, patients are often prescribed drugs indomethacin . Indomethacin . Voltaren .
In the course of complex treatment of autoimmune thyroiditis are also used vitamin complexes, adaptogens, means for correction of immunity.
If the thyroid function is reduced, for the treatment assigned to receive synthetic thyroid hormones. Because of the slow progression of the disease timely prescription treatment helps slow down the process considerably, and in the long term treatment helps to achieve long-term remission.
Appointment receiving thyroid hormone advisable for several reasons. This drug inhibits the production of the pituitary gland to effectively stimulating hormone, thereby reducing goiter . In addition, it helps to prevent the manifestation of the reception failure of the thyroid gland and decreased levels of thyroid hormones. The drug also neutralizes blood lymphocytes, provoking damage and the subsequent destruction of the thyroid gland. Dose doctor prescribes individually. Autoimmune thyroiditis by this hormone treated throughout life.
In subacute thyroiditis applied treatment with glucocorticoids, which promote removal of inflammation and, consequently, pain and edema. Steroid drugs are also used, in particular prednisolone . Duration of treatment the doctor sets individually.
With the NSAIDs can reduce the degree of inflammation of the thyroid gland, and to receive the immunosuppressive effect. But these drugs are effective only in the case of mild subacute thyroiditis. More often than not the right approach to the treatment of the patient can be cured in a few days. But it happens that the disease last longer and manifest its recurrence.
In the treatment of asymptomatic thyroiditis taken into account the fact that the disease often resolves spontaneously. Therefore, treatment of the disease is made exclusively by means of P-adrenergic blockade propranolol . Surgery and radioiodterapiya not allowed.
If there is some evidence of the attending doctor prescribes surgery, called thyroidectomy. Operation is inevitable in the case of a combination of autoimmune thyroiditis with neoplastic process; large goiter, which compresses the organs of the neck, or progressively increasing crop; lack of effect of conservative treatment for six months; the presence of fibrous thyroiditis.
There are also some traditional treatments thyroiditis. If this disease is recommended to use an external alcohol tincture of pine cones - with the help of rubbing produced. There is also a method of juice therapy, according to which every day you need to take the juice of beets and carrots, lemon juice.
Prevention thyroiditis
Prevent the manifestation of acute or subacute thyroiditis by means of specific preventive measures to date is not possible. But experts advise to follow the general rules to help prevent a number of diseases. It is important to regularly hardening, time spent therapy of diseases of ears, throat, nose, teeth, drinking adequate amounts of vitamins. A person who in the family there were cases of autoimmune thyroiditis should be very attentive to their own health and consult your doctor at the first suspicion.
To avoid recurrence of the disease, it is important to carefully carry out all the doctor's instructions.
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