Silent thyroiditis

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Subacute lymphocytic thyroiditis or silent thyroiditis is a thyroid inflammatory condition, and a form of subacute thyroiditis.

Clinical presentation

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.

Pathology

Histologically, the gland demonstrates lymphocytic infiltration, occasionally to the point of lymphoid follicle formation.

Associations

human leukocyte antigen (HLA) haplotypes, most often HLA-DR3

Markers

elevated levels of thyroid peroxidase (TPO) antibodies
elevated thyroglobulin antibodies

Radiographic features

Nuclear medicine

Thyroid scintigraphy typically shows markedly reduced radioiodine uptake and markedly decreased glandular activity .

Treatment and prognosis

The course is usually self-limiting. Moderate doses of β-adrenergic blocking agents may provide symptomatic relief.