Thyroid disease is defined as a condition of malfunction of thyroid.
Hyperthyroidism is a condition in which the thyroid gland is over active
and produces too much thyroid hormones. Hypothyroidism is a condition
in which the thyroid gland is under active and produces very little
thyroid hormones. Thyroid cancer is defined as condition in which the
cells in the thyroid gland have become cancerous.
Silent thyroiditis
Silent thyroiditis is the inflammation of the thyroid gland. Patients
with silent thyroiditis are experience back and forth between
hypothyroidism and hyperthyroidism. The disease classically present with
a triphasic course: a brief period of thyrotoxicosis due to release of
preformed thyroid hormone that lasts for 1 to 3 months, followed by a
more prolonged hypothyroid phase lasting up to 6 months, and eventual
return to a euthyroid state. However, the types and degree of thyroid
dysfunction are variable in these disorders, and individual patients may
present with mild or more severe cases of thyrotoxicosis alone,
hypothyroidism alone, or both types of thyroid dysfunction(a).
C.2. Diseases associated to Silent thyroiditis
1. Rheumatoid arthritis
There is a report of a 41-year-old female with rheumatoid arthritis had
nontender enlarged thyroid gland. Thyroid function tests revealed
increased concentrations of serum free T3 (FT3, 10.8 pmol/L) and free T4
(FT4, 31.1 pmol/L) with suppressed concentration of thyrotropin (TSH,
lower than 0.1 mU/L) and low 24-hour thyroidal radioactive iodine uptake
(1.6%). Serum thyrotropin receptor antibody (TRAb) was negative (0%)
and she had positive anti-thyroglobulin and anti-microsomal
antibodies(29).
2. Graves’ disease
There is a report of a patient who developed silent thyroiditis during
the course of Graves’ disease, according to the study by the Fourth
Department of Internal Medicine, Saitama Medical School(30).
Other study indicated that Silent thyroiditis (ST) and Graves’ disease
(GD) are two clinical entities belonging to the wide spectrum of
autoimmune thyroid diseases (AITD). The two diseases are closely linked
because sequential development of GD followed by ST, or the reverse
course of events(31).
3. Progressive systemic sclerosis (PSS)
There is a report of a patient with progressive systemic sclerosis (PSS)
who had increased serum T3 (235 ng/dl) and T4 (13.2 micrograms/dl) and
low 24-h thyroidal 123I-uptake (1.2%). A diagnosis of silent thyroiditis
was made on the basis of the clinical course and laboratory and
histopathologic findings(32).
4. Idiopathic thrombocytopenic purpura (I.T.P.)
There is a report of a 51-year-old woman had symptoms of thyrotoxicosis
which disappeared spontaneously within two months. She was diagnosed as a
case of silent thyroiditis on the basis of both the clinical course and
the laboratory data such as low uptake of radioactive iodine and
technesium. She also had petechiae in her arms which were diagnosed as
an idiopathic thrombocytopenic purpura (I.T.P.)(33).
5. Thymoma
Thymoma often accompanies an autoimmune disease as a paraneoplastic
syndrome, and an immunological mechanism is thought to be involved in
the onset of silent thyroiditis(34).
6. Chronic adrenocortical insufficiency
There is report of a case of a 23-year-old woman had silent thyrotoxic
thyroiditis and chronic adrenocortical insufficiency (Addison’s
disease)(35).
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Sources
(a) http://www.ncbi.nlm.nih.gov/pubmed/22443972
(29) http://www.ncbi.nlm.nih.gov/pubmed/1506621
(30) http://www.ncbi.nlm.nih.gov/pubmed/1688049
(31) http://www.ncbi.nlm.nih.gov/pubmed/10595464
(32) http://www.ncbi.nlm.nih.gov/pubmed/1794333
(33) http://www.ncbi.nlm.nih.gov/pubmed/3250857
(34) http://www.ncbi.nlm.nih.gov/pubmed/9711887
(35) http://www.ncbi.nlm.nih.gov/pubmed/7396620
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