Thyroiditis, shalya tantra

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1. Chronic lymphocitic thyroiditis:-

  This is common condition is associated with raised titres of thyroid antibodies. It presents as multinodular goitre with established or subclinical thyroid failure. Primary myxoedema without detectable thyroid enlargement represents the terminal stage the pathological process.

Clinical features:-

  • Gradual and asymptomatic or sudden and painful
  • Mild hyperthyroidism initialy, hypothyroidism sets in gradually.
  • Goitre is lobulated, diffused or localised to one lobe
  • Commonest in women, at menopause.
  • On investigation, raised titres of thyroid antibodies are present. FNAC is the confirmatory procedure.


Treatment:-
  • Full replacement dosage of thyroxine for hypothyroidism 
  • Steroid therapy, if thyroid enlarges inspite of harmone treatment .
  • In case , thyroid enlarges causing discomfort, thyroidectomy is advised.
2.Granulomatous thyroiditis 

 Caused due to a virus infection
C/F- Fever, malaise, pain in neck; with a firm, irregular enlargement of one or both lobes of thyroid.

  • Condition is self limiting and within few months the goitre subsides.
  • In acute cases, with severe pain, prednisone 10 - 20 mg daily for 7 days , then dose is gradually reduced.


3. Riedel thyroiditis -
Rare types of goitre, wherein thyroid tisse is replaced by celluar fibrous tisse which infiltrates through the capsule into the adjacent muscles etc.The goitre may be unilateral or bilateral, hard and fixed.

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