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Chronic Autoimmune Thyroiditis

  • Andrea Carbone
  • Mario Rotondi
  • Luca ChiovatoEmail author
Chapter

Abstract

Thyroiditis encompasses a heterogeneous group of acute, subacute, and chronic inflammatory disorders of the thyroid, of which etiologies range from autoimmune to infectious origins. Patients can be euthyroid, may experience transient phases of thyrotoxicosis and/or hypothyroidism, or may progress to permanent hypothyroidism. Chronic autoimmune thyroiditis presents with two clinical entities: a goitrous form (Hashimoto’s thyroiditis) and an atrophic form (atrophic thyroiditis or primary myxedema). Treatment with immunosuppressive agents (corticosteroids) is not recommended in autoimmune thyroiditis. Lifelong substitution therapy with l-thyroxine is indicated in hypothyroid patients. Among children living in areas of iodine sufficiency, juvenile lymphocytic thyroiditis is the cause of euthyroid goiter in about one-half to two-thirds of patients. Silent thyroiditis is characterized by transient thyrotoxicosis with low thyroid radioiodine uptake and a small, painless, nontender goiter. The postpartum rebound of immunity may be accompanied by destructive thyroiditis (postpartum thyroiditis), resulting in transient thyrotoxicosis evolving to hypothyroidism, or hypothyroidism alone, followed by gradual recovery.

Keywords

Chronic autoimmune thyroiditis Thyroid autoimmunity Hashimoto’s thyroiditis Atrophic thyroiditis Juvenile thyroiditis Silent thyroiditis Postpartum thyroiditis 

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© Springer International Publishing AG, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Istituti Clinici Scientifici MaugeriPaviaItaly

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