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Painless lymphocytic thyroiditis

Última revisión: 12 Dec 2025
Última actualización: 10 Dec 2024

Resumen

Definición

Anamnesis y examen

Principales factores de diagnóstico

  • heat intolerance
  • nervousness
  • small nontender goiter
  • tremulousness
Todos los datos

Otros factores de diagnóstico

  • palpitations
  • weight loss
  • excessive fatigue
  • bloating
  • muscle cramps
  • weight gain
  • poor concentration
  • cold intolerance
  • tachycardia
Todos los datos

Factores de riesgo

  • postpartum period
  • female sex
  • thyroid peroxidase (TPO) antibodies
  • imunnomodulatory therapy
  • lithium therapy
  • amiodarone therapy
  • type 1 diabetes and other autoimmune conditions
  • autoimmune family history
Todos los datos

Pruebas diagnósticas

Primeras pruebas diagnósticas para solicitar

  • thyroid-stimulating hormone (TSH)
  • serum free T4 and T3
  • TPO (thyroid peroxidase) antibodies
  • TSH-receptor antibodies (TRAb)
  • 4-, 6-, or 24-hour radioiodine uptake
  • total T3/T4 ratio
Todos los datos

Pruebas diagnósticas que deben considerarse

  • technetium-99m pertechnetate scan
  • serum thyroglobulin
  • thyroid biopsy
  • thyroid ultrasound
Todos los datos

Algoritmo de tratamiento

Agudo

thyrotoxic (hyperthyroid) phase: mild

thyrotoxic (hyperthyroid) phase: moderate

thyrotoxic (hyperthyroid) phase: severe

En curso

hypothyroid phase: mild

hypothyroid phase: moderate to severe

recurrent thyroiditis

Colaboradores

Autores

Petros Perros, MD

Honorary Consultant

Department of Endocrinology

Newcastle upon Tyne Hospitals NHS Foundation Trust

Newcastle upon Tyne

UK

Divulgaciones

PP has received consultancy fees, served as a member of an advisory board, and been reimbursed for attending conferences held by IBSA Institut Biochimique SA (the manufacturer of Tirosint).

Agradecimientos

Dr Petros Perros would like to gratefully acknowledge Dr Douglas S. Ross, the previous contributor to this topic. DSR declares that he has no competing interests.

Revisores por pares

John Lazarus, MA, MD, FRCP, FACE, FRCOG

Centre for Endocrine and Diabetes Sciences

Cardiff University School of Medicine

University Hospital of Wales

Heath Park

Cardiff

UK

Divulgaciones

JL declares that he has no competing interests.

Ronald Merrell, MD

Professor of Surgery

Virginia Commonwealth University

Richmond

VA

Раскрытие информации

RM declares that he has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

Список литературы

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Основные статьи

Muller I, Moran C, Lecumberri B, et al. 2019 European Thyroid Association guidelines on the management of thyroid dysfunction following immune reconstitution therapy. Eur Thyroid J. 2019 Jul;8(4):173-85.Полный текст  Аннотация

National Institute for Health and Care Excellence. Thyroid disease: assessment and management. Oct 2023 [internet publication].Полный текст

Ross DS, Burch HB, Cooper DS, et al. 2016 American Thyroid Association guidelines for diagnosis and management of hyperthyroidism and other causes of thyrotoxicosis. Thyroid. 2016 Oct;26(10):1343-421.Полный текст  Аннотация

Статьи, указанные как источники

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