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Hyperthyroidism
Published in Pallavi Iyer, Herbert Chen, Thyroid and Parathyroid Disorders in Children, 2020
Occasionally a child presents with hyperthyroidism, tenderness over the thyroid gland, and fever due to bacterial infection of the thyroid, a condition called acute thyroiditis. Acute thyroiditis can be associated with the presence of a fistula connecting the piriform sinus on the left side of the pharynx to the thyroid. Fevers can be high, and erythrocyte sedimentation rates and white counts elevated. Ultrasonography may reveal a local abscess. In contrast to GD, uptake of technetium 99-pertechnetate or radioiodine is reduced when thyroid scanning is performed.
Endocrine tumours
Published in Peter Hoskin, Peter Ostler, Clinical Oncology, 2020
Severe adverse reactions to radioiodine are rare. Possible complications include nausea, acute parotitis, sore throat from radiation laryngitis and acute pneumonitis if there are miliary lung metastases. Rarely there may be myelosuppression, leukaemogenesis and induction of cancer elsewhere (there is some uptake in the salivary glands, stomach, colon and bladder). Acute thyroiditis is also recognized – this may cause temporary upper airway obstruction in severe cases. It settles quickly with corticosteroids. Radiation protection protocols should prevent radiation exposure to staff and relatives of those receiving high doses of radioiodine.
Applications of Radioisotopes in the Diagnosis and Treatment of Thyroid Disorders
Published in Madan Laxman Kapre, Thyroid Surgery, 2020
Chandrasekhar Bal, Meghana Prabhu, Dhritiman Chakraborty, K. Sreenivasa Reddy, Saurabh Arora
Thyroiditis: It is the most common cause of thyrotoxicosis associated with a decreased %RAIU. Various causes include granulomatous thyroiditis (de Quervain), silent thyroiditis, and postpartum thyroiditis (occurs within a few weeks of delivery, with positive antithyroid antibodies). During the initial stage of sub-acute thyroiditis, thyrotoxicosis predominates, caused by the release of thyroid hormone as a result of inflammation and increased membrane permeability and hence suppresses TSH. As the inflammation resolves and thyroid hormone levels decrease, the scintigram may show inhomogeneity of uptake or regional or focal areas of hypofunction (Figure 21.1a and b).
Thyrotoxicosis secondary to thyroiditis following SARS-CoV-2 infection
Published in Journal of Endocrinology, Metabolism and Diabetes of South Africa, 2021
Ankia Coetzee, Raisa Bhikoo, Bianca Berndorfler, Wilhelmina Conradie, Jantjie J Taljaard, Marli Conradie-Smit
Thyroid scintigraphy is an important imaging modality in the evaluation of thyrotoxic patients and allows for the differentiation of hyperthyroidism from other causes of thyrotoxicosis. In cases of Graves’ disease, or nodular thyroid disease with autonomous function, various patterns of increased uptake are seen. In the early thyrotoxic phase of subacute thyroiditis, decreased or absent uptake is observed.8 It can be confirmed semi-quantitatively by calculating the percentage of thyroid uptake. Differential diagnoses to consider with decreased or absent thyroid uptake in the context of thyrotoxicosis include other types of thyroiditis (subacute thyroiditis, amiodarone-induced thyroiditis, acute thyroiditis), iatrogenic or factitious thyrotoxicosis (due to exogenous thyroxine) and ectopic hyperfunctioning thyroid tissue.9. The role of thyroid ultrasound in diffusely enlarged thyroid glands is to exclude pathology undetectable on clinical examination and, in the case of a painful gland, the exclusion of suppurative thyroiditis. It also enables fine-needle aspiration if malignancy is suspected. The characteristics in subacute thyroiditis include patchy poorly circumscribed hypoechoic areas with decreased vascularity on doppler.10 Lee categorises these changes into nodular, non-nodular and mixed subtypes that can be focal or multifocal, unilateral or bilateral.11 These findings can overlap with malignancy and other forms of thyroiditis, therefore clinical correlation is of utmost importance. Most changes normalise after one year, but nodular change might persist.10
Cost-effectiveness of alemtuzumab and natalizumab for relapsing-remitting multiple sclerosis treatment in Iran: decision analysis based on an indirect comparison
Published in Journal of Medical Economics, 2019
Saeed Taheri, Mohammad Ali Sahraian, Nazila Yousefi
ITP has been observed in ∼2% of patients treated with ALM57. Glucocorticoids and intravenous immune globulin (IVIG) are used as first-line therapy for the initial treatment of ITP81. The cumulative proportion of patients experiencing autoimmune thyroid disorders over a follow-up of 5 years was 39%, with the most common types comprising Graves’ hyperthyroidism (65.8%), hypothyroidism (20.5%), and sub-acute thyroiditis (12.3%)82. Therefore, an average cost of conventional therapies of thyroid disorders with anti-thyroid drugs, radioactive iodine, thyroid hormone, or surgery based on the proportion of different observed types of thyroid disorders were calculated and used in the model.
Acute Thyroiditis and Bilateral Optic Neuritis following SARS-CoV-2 Vaccination with CoronaVac: A Case Report
Published in Ocular Immunology and Inflammation, 2021
Henrique M. Leber, Leticia Sant’Ana, Nina R. Konichi da Silva, Mariana C. Raio, Thiago Jose Muniz Machado Mazzeo, Camila Matsuura Endo, Heloisa Nascimento, Carlos E. de Souza
Although the association between immunization and the onset of demyelinating manifestations of the central nervous system is well documented, this report is the first case of acute thyroiditis and optic neuritis after vaccination against SARS-CoV-2.