tiroiditis

tatalaksana

Obat-obatan termasuk obat anti-radang non-steroid (nonsteroidal anti-inflammatory drug/NSAID) atau prednisone untuk rasa sakit. Bisa juga menggunakan beta-blocker propranolol atau atenolol,

Anatomy

Glandula Thyroidea

Regulation and sistesis

sintesis

regulation 

  • Kadar hormon tiroid bebas yang rendah merangsang pelepasan TRH dari hipothalamus

  • TRH selanjutnya memasuki sirkulasi darah hipofisis dan menstimulasi sel sel tirotrop untuk melepaskan TSH kedalam sirkulasi sistemik

  • TSH menggalakkan peningkatan sintesis dan sekresi hormon tiroid melalui upregulasi proses ambilan iodida, organifikasi, coupling dan pinositosis material koloid

  • TSH juga memberikan efek trofik pada kelenjar tiroid dengan meningkatkan ukurannya melalui sintesis proteinn yang berlanjut

image

Definition & klasification

definition

Thyroiditis is inflammation (swelling) of the thyroid. The thyroid is a small gland in the neck that plays an important role in controlling metabolism. Inflammation can result in increased thyroid (hyperthyroidism) or reduced thyroid activity (hypothyroidism).


The most common type is Hashimoto's thyroid inflammation. Other forms of inflammation (swelling) of the thyroids such as subacute thyroiditis and silent thyroiditis can cause hyperthyroidism. Postpartum thyroiditis may also occur in women who have recently given birth.

klasifikasi

Hashimoto's thyroiditis.

Postpartum thyroiditis.

Iodine deficiency.

A non-functioning thyroid gland.

etiologi & faktor resiko

Thyroiditis is caused by an attack on the thyroid, causing inflammation and damage to the thyroid cells. Antibodies that attack the thyroid cause most types of thyroiditis. As such, thyroiditis is often an autoimmune disease, like juvenile (type 1) diabetes and rheumatoid arthritis. It is not known why certain people make anti-thyroid antibodies, although this tends to run in families. Thyroiditis can also be caused by an infection, such as a virus or bacteria, which can also cause inflammation in the gland. Finally, drugs such as interferon and amiodarone, can also damage thyroid cells and cause thyroiditis.

faktor resiko

Have a family history of thyroid disease.

Have a medical condition (these can include pernicious anemia, type 1 diabetes, primary adrenal insufficiency, lupus, rheumatoid arthritis, Sjögren’s syndrome and Turner syndrome).

Take a medication that’s high in iodine (amiodarone).

Are older than 60, especially in women.

Have had treatment for a past thyroid condition or cancer (thyroidectomy or radiation).

Pathophysiology and clinical manifestation

Hashimoto’s Thyroiditis

Painless and Post-Partum Thyroiditis

Subacute Thyroiditis

Drug-Induced and Radiation Thyroiditis

Acute/Infectious Thyroiditis

How to diagnose

anamnesis

pemeriksaan fisik

laboratory test

DIFFERENTIAL DIAGNOSE

Acute hemorrhage into thyroid cyst

Thyroid nodule

Thyroid cancer

Tonsilitis

Acute pharyngitis

Complication

Myxedema coma is the term given to the most severe presentation of profound hypothyroidism and is often fatal in spite of therapy.

It typically presents in older women in the winter months and is associated with signs of hypothyroidism, hypothermia, hyponatremia, hypercarbia, and hypoxemia.

Homeostasis might no longer be maintained in severely hypothyroid patients if blood volume is reduced any further (e.g. by gastrointestinal bleeding or the use of diuretics), if respiration already compromised by a reduced ventilatory drive is further hampered by intercurrent pulmonary infection, of if CNS regulatory mechanisms are impaired by stroke, the use of sedatives, or hyponatremia.

EDUCATION

Unfortunately, most cases of thyroiditis can’t be prevented

If you had condition that requires treatment using radioactive iodine or radiation therapy, talk to your healthcare about risk of thyroiditis

If you take prescription drugs that can cause thyroiditis, talk to the provider about risk and ask about what happend if you stop taking the medicine