Skip to main content
SpringerLink
Log in

Thyroiditis

  • Chapter
  • First Online:
Surgery of the Thyroid and Parathyroid Glands

  • 2425 Accesses

Abstract

The term thyroiditis summarizes a heterogeneous group of inflammatory diseases of the thyroid. Thyroiditis represents up to 20% of all thyroid diseases and is caused by multiple factors (Table 10.1). According to the clinical course, thyroiditises are classified into acute, subacute, chronic, and subclinical form. Once a suppurative inflammation has been ruled out, most other types of thyroiditis have either a definitive autoimmune etiology or are possibly autoimmune in nature. Autoimmune diseases represent the most common etiologies. Hashimoto’s thyroiditis is the most frequent form of chronic lymphocytic thyroiditises. Subacute forms are subdivided according to the predominant type of inflammation (i.e., granulomatous or lymphocytic). The quite rare fibro-inflammatory process, well known as Riedel’s thyroiditis, is also treated by this chapter. Clinically, patients may present either with an acute illness with severe thyroid pain (e.g., acute suppurative thyroiditis, subacute de Quervain’s thyroiditis, radiation thyroiditis, traumatic thyroiditis) or without evident inflammation but with thyroid dysfunction and/or a goiter (e.g., silent thyroiditis, Hashimoto’s or Riedel’s thyroiditis).

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Sheu SY, Schmid KW (2003) Inflammatory diseases of the thyroid gland. Epidemiology, symptoms and morphology. Pathologe 24(5):339–347

    Article  PubMed  Google Scholar 

  2. Khan A, Nosé V (2004) Pathology of the thyroid gland. In: Lloyd RV (ed) Endocrine pathology. Humana, Totowa, pp 153–189

    Google Scholar 

  3. Brook I (2003) Microbiology and management of acute suppurative thyroiditis in children. Int J Pediatr Otorhinolaryngol 67(5):447–451

    Article  PubMed  Google Scholar 

  4. Chang P, Tsai WY, Lee PI et al (2002) Clinical characteristics and management of acute suppurative thyroiditis in children. J Formos Med Assoc 101(7):468–471

    PubMed  Google Scholar 

  5. Chi H, Lee YJ, Chiu NC et al (2002) Acute suppurative thyroiditis in children. Pediatr Infect Dis J 21(5):384–387

    Article  PubMed  Google Scholar 

  6. Farwell AP, Braverman LE (1996) Inflammatory thyroid disorders. Otolaryngol Clin North Am 29(4):541–556

    PubMed  CAS  Google Scholar 

  7. Berger SA, Zonszein J, Villamena P et al (1983) Infectious diseases of the thyroid gland. Rev Infect Dis 5(1):108–122

    Article  PubMed  CAS  Google Scholar 

  8. Guttler R, Singer PA, Axline SG et al (1993) Pneumocystis carinii thyroiditis. Report of three cases and review of the literature. Arch Intern Med 153(3):393–396

    Article  PubMed  CAS  Google Scholar 

  9. Jeng LB, Lin JD, Chen MF (1994) Acute suppurative thyroiditis: a ten-year review in a Taiwanese hospital. Scand J Infect Dis 26(3):297–300

    Article  PubMed  CAS  Google Scholar 

  10. Seki N, Himi T (2007) Retrospective review of 13 cases of pyriform sinus fistula. Am J Otolaryngol 28(1):55–58

    Article  PubMed  Google Scholar 

  11. Kobayashi A, Kuma K, Matsuzuka F et al (1992) Thyrotoxicosis after needle aspiration of thyroid cyst. J Clin Endocrinol Metab 75(1):21–24

    Article  PubMed  CAS  Google Scholar 

  12. Nishihara E, Miyauchi A, Matsuzuka F et al (2005) Acute suppurative thyroiditis after fine-needle aspiration causing thyrotoxicosis. Thyroid 15(10):1183–1187

    Article  PubMed  Google Scholar 

  13. Tien KJ, Chen TC, Hsieh MC et al (2007) Acute suppurative thyroiditis with deep neck infection: a case report. Thyroid 17(5):467–469

    Article  PubMed  Google Scholar 

  14. Pearce EN, Farwell AP, Braverman LE (2003) Thyroiditis. N Engl J Med 348(26):2646–2655

    Article  PubMed  Google Scholar 

  15. Rich EJ, Mendelman PM (1987) Acute suppurative thyroiditis in pediatric patients. Pediatr Infect Dis J 6(10):936–940

    Article  PubMed  CAS  Google Scholar 

  16. Fukata S, Miyauchi A, Kuma K et al (2002) Acute suppurative thyroiditis caused by an infected piriform sinus fistula with thyrotoxicosis. Thyroid 12(2):175–178

    Article  PubMed  Google Scholar 

  17. Sicilia V, Mezitis S (2006) A case of acute suppurative thyroiditis complicated by thyrotoxicosis. J Endocrinol Invest 29(11):997–1000

    PubMed  CAS  Google Scholar 

  18. Lin KD, Lin JD, Huang MJ et al (1998) Acute suppurative thyroiditis and aggressive malignant thyroid tumors: differences in clinical presentation. J Surg Oncol 67(1):28–32

    Article  PubMed  CAS  Google Scholar 

  19. Volpe R (1993) The management of subacute (De Quervain’s) thyroiditis. Thyroid 3(3):253–255

    Article  PubMed  CAS  Google Scholar 

  20. Sniezek JC, Francis TB (2003) Inflammatory thyroid disorders. Otolaryngol Clin North Am 36(1):55–71

    Article  PubMed  Google Scholar 

  21. Ogawa E, Katsushima Y, Fujiwara I et al (2003) Subacute thyroiditis in children: patient report and review of the literature. J Pediatr Endocrinol Metab 16(6):897–900

    Article  PubMed  Google Scholar 

  22. Pearce EN, Bogazzi F, Martino E et al (2003) The prevalence of elevated serum C-reactive protein levels in inflammatory and noninflammatory thyroid disease. Thyroid 13(7):643–648

    Article  PubMed  Google Scholar 

  23. Sherman SI, Ladenson PW (2007) Subacute thyroiditis causing thyroid storm. Thyroid 17(3):283

    Article  PubMed  Google Scholar 

  24. Swinburne JL, Kreisman SH (2007) A rare case of subacute thyroiditis causing thyroid storm. Thyroid 17(1):73–76

    Article  PubMed  Google Scholar 

  25. Fatourechi V, Aniszewski JP, Fatourechi GZ et al (2003) Clinical features and outcome of subacute thyroiditis in an incidence cohort: Olmsted county, Minnesota, study. J Clin Endocrinol Metab 88(5):2100–2105

    Article  PubMed  CAS  Google Scholar 

  26. Iitaka M, Momotani N, Ishii J et al (1996) Incidence of subacute thyroiditis recurrences after a prolonged latency: 24-year survey. J Clin Endocrinol Metab 81(2):466–469

    Article  PubMed  CAS  Google Scholar 

  27. Bogazzi F, Dell’Unto E, Tanda ML et al (2006) Long-term outcome of thyroid function after amiodarone-induced thyrotoxicosis, as compared to subacute thyroiditis. J Endocrinol Invest 29(8):694–699

    PubMed  CAS  Google Scholar 

  28. Carle A, Laurberg P, Pedersen IB et al (2006) Epidemiology of subtypes of hypothyroidism in Denmark. Eur J Endocrinol 154(1):21–28

    Article  PubMed  CAS  Google Scholar 

  29. Kitchener MI, Chapman IM (1989) Subacute thyroiditis: a review of 105 cases. Clin Nucl Med 14(6):439–442

    Article  PubMed  CAS  Google Scholar 

  30. Eylan E, Zmucky R, Sheba C (1957) Mumps virus and subacute thyroiditis; evidence of a causal association. Lancet 272(6978):1062–1063

    Article  PubMed  CAS  Google Scholar 

  31. Mcarthur AM (1964) Subacute giant cell thyroiditis associated with mumps. Med J Aust 1:116–117

    PubMed  CAS  Google Scholar 

  32. Volpe R (1978) The pathology of thyroiditis. Hum Pathol 9(4):429–438

    Article  PubMed  CAS  Google Scholar 

  33. Volta C, Carano N, Street ME et al (2005) Atypical subacute thyroiditis caused by Epstein-Barr virus infection in a three-year-old girl. Thyroid 15(10):1189–1191

    Article  PubMed  Google Scholar 

  34. Martino E, Buratti L, Bartalena L et al (1987) High prevalence of subacute thyroiditis during summer season in Italy. J Endocrinol Invest 10(3):321–323

    PubMed  CAS  Google Scholar 

  35. Falaschi P, Martocchia A, D’Urso R et al (1997) Subacute thyroiditis during interferon-alpha therapy for chronic hepatitis C. J Endocrinol Invest 20(1):24–28

    PubMed  CAS  Google Scholar 

  36. Omur O, Daglyoz G, Akarca U et al (2003) Subacute thyroiditis during interferon therapy for chronic hepatitis B infection. Clin Nucl Med 28(10):864–865

    Article  PubMed  Google Scholar 

  37. Parana R, Cruz M, Lyra L et al (2000) Subacute thyroiditis during treatment with combination therapy (interferon plus ribavirin) for hepatitis C virus. J Viral Hepat 7(5):393–395

    Article  PubMed  CAS  Google Scholar 

  38. Shen L, Bui C, Mansberg R et al (2005) Thyroid dysfunction during interferon alpha therapy for chronic hepatitis C. Clin Nucl Med 30(8):546–547

    Article  PubMed  Google Scholar 

  39. Hamaguchi E, Nishimura Y, Kaneko S et al (2005) Subacute thyroiditis developed in identical twins two years apart. Endocr J 52(5):559–562

    Article  PubMed  Google Scholar 

  40. Hnilica P, Nyulassy S (1985) Plasma cells in aspirates of goitre and overt permanent hypothyroidism following subacute thyroiditis. Preliminary report. Endocrinol Exp 19(4):221–226

    PubMed  CAS  Google Scholar 

  41. Kramer AB, Roozendaal C, Dullaart RP (2004) Familial occurrence of subacute thyroiditis associated with human leukocyte antigen-B35. Thyroid 14(7):544–547

    Article  PubMed  Google Scholar 

  42. Ohsako N, Tamai H, Sudo T et al (1995) Clinical characteristics of subacute thyroiditis classified according to human leukocyte antigen typing. J Clin Endocrinol Metab 80(12):3653–3656

    Article  PubMed  CAS  Google Scholar 

  43. Hollowell JG, Staehling NW, Flanders WD et al (2002) Serum TSH, T(4), and thyroid antibodies in the United States population (1988 to 1994): national health and nutrition examination survey (NHANES III). J Clin Endocrinol Metab 87(2):489–499

    Article  PubMed  CAS  Google Scholar 

  44. Tunbridge WM, Evered DC, Hall R et al (1977) The spectrum of thyroid disease in a community: the Whickham survey. Clin Endocrinol (Oxf) 7(6):481–493

    Article  CAS  Google Scholar 

  45. Weetman AP (2001) Determinants of autoimmune thyroid disease. Nat Immunol 2(9):769–770

    Article  PubMed  CAS  Google Scholar 

  46. Dayan CM, Daniels GH (1996) Chronic autoimmune thyroiditis. N Engl J Med 335(2):99–107

    Article  PubMed  CAS  Google Scholar 

  47. Lorini R, Gastaldi R, Traggiai C et al (2003) Hashimoto’s thyroiditis. Pediatr Endocrinol Rev 1(Suppl 2):205–211

    PubMed  Google Scholar 

  48. Stagnaro-Green A (2002) Clinical review 152: postpartum thyroiditis. J Clin Endocrinol Metab 87(9):4042–4047

    Article  PubMed  CAS  Google Scholar 

  49. Rallison ML, Dobyns BM, Meikle AW et al (1991) Natural history of thyroid abnormalities: prevalence, incidence, and regression of thyroid diseases in adolescents and young adults. Am J Med 91(4):363–370

    Article  PubMed  CAS  Google Scholar 

  50. Golden B, Levin L, Ban Y et al (2005) Genetic analysis of families with autoimmune diabetes and thyroiditis: evidence for common and unique genes. J Clin Endocrinol Metab 90(8):4904–4911

    Article  PubMed  CAS  Google Scholar 

  51. Jacobson EM, Tomer Y (2007) The genetic basis of thyroid autoimmunity. Thyroid 17(10):949–961

    Article  PubMed  CAS  Google Scholar 

  52. Pankow BG, Michalak J, McGee MK (1985) Adult human thyroid weight. Health Phys 49(6):1097–1103

    Article  PubMed  CAS  Google Scholar 

  53. Fatourechi V, McConahey WM, Woolner LB (1971) Hyperthyroidism associated with histologic Hashimoto’s thyroiditis. Mayo Clin Proc 46(10):682–689

    PubMed  CAS  Google Scholar 

  54. Amino N, Tada H, Hidaka Y (1999) Postpartum autoimmune thyroid syndrome: a model of aggravation of autoimmune disease. Thyroid 9(7):705–713

    Article  PubMed  CAS  Google Scholar 

  55. Marqusee E, Hill JA, Mandel SJ (1997) Thyroiditis after pregnancy loss. J Clin Endocrinol Metab 82(8):2455–2457

    Article  PubMed  CAS  Google Scholar 

  56. Ginsberg J, Walfish PG (1977) Post-partum transient thyrotoxicosis with painless thyroiditis. Lancet 1(8022):1125–1128

    Article  PubMed  CAS  Google Scholar 

  57. Lucas A, Pizarro E, Granada ML et al (2000) Postpartum thyroiditis: epidemiology and clinical evolution in a nonselected population. Thyroid 10(1):71–77

    Article  PubMed  CAS  Google Scholar 

  58. Othman S, Phillips DI, Parkes AB et al (1990) A long-term follow-up of postpartum thyroiditis. Clin Endocrinol (Oxf) 32(5):559–564

    Article  CAS  Google Scholar 

  59. Stagnaro-Green A (2004) Postpartum thyroiditis. Best Pract Res Clin Endocrinol Metab 18(2):303–316

    Article  PubMed  CAS  Google Scholar 

  60. Mizukami Y, Michigishi T, Nonomura A et al (1993) Postpartum thyroiditis. A clinical, histologic, and immunopathologic study of 15 cases. Am J Clin Pathol 100(3):200–205

    PubMed  CAS  Google Scholar 

  61. Muller-Hocker J (2000) Expression of bcl-2, Bax and Fas in oxyphil cells of Hashimoto thyroiditis. Virchows Arch 436(6):602–607

    Article  PubMed  CAS  Google Scholar 

  62. Mittra ES, McDougall IR (2007) Recurrent silent thyroiditis: a report of four patients and review of the literature. Thyroid 17(7):671–675

    Article  PubMed  Google Scholar 

  63. Nikolai TF, Brosseau J, Kettrick MA et al (1980) Lymphocytic thyroiditis with spontaneously resolving hyperthyroidism (silent thyroiditis). Arch Intern Med 140(4):478–482

    Article  PubMed  CAS  Google Scholar 

  64. Kamikubo K, Takami R, Suwa T et al (1993) Case report: silent thyroiditis developed during alpha-interferon therapy. Am J Med Sci 306(3):174–176

    Article  PubMed  CAS  Google Scholar 

  65. Larson SD, Jackson LN, Riall TS et al (2007) Increased incidence of well-differentiated thyroid cancer associated with Hashimoto thyroiditis and the role of the PI3k/Akt pathway. J Am Coll Surg 204(5):764–773

    Article  PubMed  Google Scholar 

  66. Miller KK, Daniels GH (2001) Association between lithium use and thyrotoxicosis caused by silent thyroiditis. Clin Endocrinol (Oxf) 55(4):501–508

    Article  CAS  Google Scholar 

  67. de Lange WE, Freling NJ, Molenaar WM et al (1989) Invasive fibrous thyroiditis (Riedel’s struma): a manifestation of multifocal fibrosclerosis? A case report with review of the literature. Q J Med 72(268):709–717

    PubMed  Google Scholar 

  68. Papi G, LiVolsi VA (2004) Current concepts on Riedel thyroiditis. Am J Clin Pathol 121(Suppl):S50–S63

    PubMed  Google Scholar 

  69. Schwaegerle SM, Bauer TW, Esselstyn CB Jr (1988) Riedel’s thyroiditis. Am J Clin Pathol 90(6):715–722

    PubMed  CAS  Google Scholar 

  70. Hay ID (1985) Thyroiditis: a clinical update. Mayo Clin Proc 60(12):836–843

    PubMed  CAS  Google Scholar 

  71. Heufelder AE, Goellner JR, Bahn RS et al (1996) Tissue eosinophilia and eosinophil degranulation in Riedel’s invasive fibrous thyroiditis. J Clin Endocrinol Metab 81(3):977–984

    Article  PubMed  CAS  Google Scholar 

  72. Bagnasco M, Passalacqua G, Pronzato C et al (1995) Fibrous invasive (Riedel’s) thyroiditis with critical response to steroid treatment. J Endocrinol Invest 18(4):305–307

    PubMed  CAS  Google Scholar 

  73. Porter N, Beynon HL, Randeva HS (2003) Endocrine and reproductive manifestations of sarcoidosis. QJM 96(8):553–561

    Article  PubMed  CAS  Google Scholar 

  74. Preziati D, La RL, Covini G et al (1995) Autoimmunity and thyroid function in patients with chronic active hepatitis treated with recombinant interferon alpha-2a. Eur J Endocrinol 132(5):587–593

    Article  PubMed  CAS  Google Scholar 

  75. Roti E, Minelli R, Giuberti T et al (1996) Multiple changes in thyroid function in patients with chronic active HCV hepatitis treated with recombinant interferon-alpha. Am J Med 101(5):482–487

    Article  PubMed  CAS  Google Scholar 

  76. Deutsch M, Dourakis S, Manesis EK et al (1997) Thyroid abnormalities in chronic viral hepatitis and their relationship to interferon alfa therapy. Hepatology 26(1):206–210

    Article  PubMed  CAS  Google Scholar 

  77. Schwartzentruber DJ, White DE, Zweig MH et al (1991) Thyroid dysfunction associated with immunotherapy for patients with cancer. Cancer 68(11):2384–2390

    Article  PubMed  CAS  Google Scholar 

  78. Harjai KJ, Licata AA (1997) Effects of amiodarone on thyroid function. Ann Intern Med 126(1):63–73

    PubMed  CAS  Google Scholar 

  79. Manson CM, Cross P, De SB (1992) Post-operative necrotizing granulomas of the thyroid. Histopathology 21(4):392–393

    Article  PubMed  CAS  Google Scholar 

  80. McDermott A, Onyeaka CV, Macnamara M (2002) Surgery-induced thyroiditis: fact or fiction? Ear Nose Throat J 81(6):408–410

    PubMed  Google Scholar 

  81. Lindsay S, Dailey ME, Jones MD (1954) Histologic effects of various types of ionizing radiation on normal and hyperplastic human thyroid glands. J Clin Endocrinol Metab 14(10):1179–1218

    Article  PubMed  CAS  Google Scholar 

  82. Nishiyama K, Kozuka T, Higashihara T et al (1996) Acute radiation thyroiditis. Int J Radiat Oncol Biol Phys 36(5):1221–1224

    Article  PubMed  CAS  Google Scholar 

  83. Röher HD, Schulte KM (2010) Operative therapie bei thyreoiditis. In: Rothmund M, Harder F, Siewert JR (eds) Praxis der viszeralchirurgie: endokrine chirurgie. Springer, Berlin/Heidelberg/New York, pp 199–202

    Google Scholar 

  84. Kon YC, DeGroot LJ (2003) Painful Hashimoto’s thyroiditis as an indication for thyroidectomy: clinical characteristics and outcome in seven patients. J Clin Endocrinol Metab 88(6):2667–2672

    Article  PubMed  CAS  Google Scholar 

  85. Piga M, Serra A, Boi F et al (2008) Amiodarone-induced thyrotoxicosis. A review. Minerva Endocrinol 33(3):213–228

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Klinik für Allgemein-, Viszeral- und Thoraxchirurgie, Diakoniekrankenhaus Rotenburg gGmbH, Elise-Averdieck-Strasse 17, 27356, Rotenburg, Germany

    Oleg Heizmann M.D.

  2. Division of General Surgery, Department of Surgery, University Hospital Basel, Spitalstrasse 21, CH-4031, Basel, Switzerland

    Daniel Oertli M.D.

Authors
  1. Oleg Heizmann M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Daniel Oertli M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Oleg Heizmann M.D. .

Editor information

Editors and Affiliations

  1. Chairman, Department of Surgery, University Hospital Basel, Spitalstr. 21, Basel, 4031, Switzerland

    Daniel Oertli

  2. Yale-New Haven Hospital, Department of Surgery, Yale University School of Medicine, Cedar Street 330FMB 102, New Haven, CT, 06520-8062, USA

    Robert Udelsman

Rights and permissions

Reprints and permissions

Copyright information

© 2012 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Heizmann, O., Oertli, D. (2012). Thyroiditis. In: Oertli, D., Udelsman, R. (eds) Surgery of the Thyroid and Parathyroid Glands. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-23459-0_10

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-23459-0_10

  • Published:

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-23458-3

  • Online ISBN: 978-3-642-23459-0

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation