Subacute lymphocytic thyroiditis
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Usually characterized by the recent onset of symptoms and there is usually an absence of thyroidal pain or tenderness. On examination there can be a normal to moderately enlarged and firm thyroid gland. There is often transient hyperthyroidism, followed sometimes by hypothyroidism, and then recovery.
Histologically, the gland demonstrates lymphocytic infiltration, occasionally to the point of lymphoid follicle formation.
- human leukocyte antigen (HLA) haplotypes, most often HLA-DR3
- elevated levels of thyroid peroxidase (TPO) antibodies
- elevated thyroglobulin antibodies
Thyroid scintigraphy typically shows markedly reduced radioiodine uptake and markedly decreased glandular activity 2.
Treatment and prognosis
The course is usually self-limiting. Moderate doses of β-adrenergic blocking agents may provide symptomatic relief.