Hypothyroidism, Hyperthyroidism, and Thyroiditis

This is a brief video on assorted thyroid diseases, including those that cause hypothyroidism, hyperthyroidism, and inflammation of the thyroid.

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ADDITIONAL TAGS:
fatigue, cold intolerance, impaired memory/concentration, constipation, weight gain, poor appetite, SoB, hoarseness, dry skin, myxedema, periorbital swelling, carpal tunnel glycosaminoglycans (thyroid hormones mediate GAG reuptake)
Can progress to myxedema coma
Bradycardia, hypotension, hypothermia
administer hormone
Hypothyroidism
Congenital hypothyroidism
Other hypothyroidism
Hashimoto thyroiditis
Subacute thyroiditis
Fibrous thyroiditis
Hyperthyroidism
Graves disease
Toxic multinodular goiter
Jod-Basedow phenomenon
Congenital hypothyroidism
cretinism
thyroid peroxidase (causing thyroid dysgenesis)
Thyroid agenesis
Maternal hypothyroidism
Iodine deficiency
: poor brain development; pale; protruding tongue; protruding umbilicus; pot-bellied; puffy face
Hypopituitarism of any cause (secondary hypothyroidism)
: lithium, amiodarone,
Amiodarone molecule has iodines; excess iodine physiologically decreases hormone production
Wolff-Chaikoff downregulates thyroid peroxidase
Iodine deficiency
Commiodine-deficient parts of world, very rare United States
AKA autoimmune primary hypothyroidism or chronic lymphocytic thyroiditis
Most commcause the US
Autoimmune
High titer of antithyroid Ab
follicular rupture
Gross: firm, nontender, enlarged
Hurthle cells (epithelial cells pink changes to epithelium → oncocytic metaplasia); lymphoid aggregates (mix of large and small cells) germinal centers (so think chronic inflammation)
Typically permanent
Associated HLA-DR5
Increased risk of non-Hodgklymphoma, often arising from B-cells marginal zone
AKA granulomatous thyroiditis or de Quervain's
hyperthyroidism, often euthyroid ,
follows viral infection
Clinical: Tender thyroid, painful the jaw, ESR
Gross: asymmetrically enlarged, fibrotic, very tender exam
granulomas; follicles replaced histiocytes and giant cells; fibrosis
Treat NSAIDs, prednisone
dense fibrosis
hard as rock stone
IgG4-related disease (IgG4-RD), systemic disease, associated infiltrati IgG4 secreting plasma nervousness, irritability, perspiration, palpitations, hand tremors, anxiety, difficulty sleeping, increased appetite, weight loss, hyperdefecation, malabsorption, thinning skin, brittle hair, upper/lower extremity muscular weakness, stare or lid retractieyes,