Subacute Thyroiditis
Subacute thyroiditis (or granulomatous or giant cells or de Quervain’s thyroiditis) is reported in Chapter 3.2.6.
Painless Thyroiditis
Painless thyroiditis (or sporadic or silent thyroiditis) is an autoimmune thyroid disorder, characterized by a transient phase of thyrotoxicosis, similar to subacute thyroiditis, in absence of neck pain and general symptoms.
Postpartum Thyroiditis
Postpartum thyroiditis (PPT) is the painless thyroiditis that occurs in susceptible women within 12 months after delivery.
Other Forms of Destructive Thyrotoxicosis
Rarely, destructive thyrotoxicosis can be precipitated by anterior neck injuries. Thyrotoxic crises following thyroid surgery have now become extremely rare with the optimal use of antithyroid drugs and with the refinement of surgical procedures. Thyrotoxicosis may transiently worsen or recur in patients with Graves’ disease, toxic adenomas, and multinodular toxic goitre who are treated with radioiodine. Two mechanisms are responsible for this phenomenon: ongoing thyroid hyperfunction before radioiodine fully takes effect and radiation- induced thyroid destruction.
Iodine- Induced Thyrotoxicosis
Iodine deficiency increases thyrocyte proliferation and mutation rates, inducing the development of multifocal autonomous growth and of cell clones harbouring activating mutations of the TSHR.
Some of these nodules maintain the ability to store iodine and can become autonomous causing thyrotoxicosis after iodine load or even iodine supplementation. Iodine- induced thyrotoxicosis is by far more prevalent in aged patients and in areas of iodine deficiency. Another predisposing condition is euthyroid or la tent Graves’ disease or Graves’ disease in remission. In individual thyrotoxic patients, iodine contamination may be caused by a variety of medications and diagnostics, including lipid- soluble contrast media, disinfectants and drugs and some foods containing large amounts of iodine.
