One of the most common thyroid pathologies is thyroiditis. This is an inflammation of the organ tissue due to various influences, from injuries to malfunctions of the immune system and the formation of aggression against one’s own tissues. Often with thyroiditis, hormone production progressively suffers, which ultimately leads to the development of severe hypothyroidism. In many cases, the initial stages of thyroiditis are asymptomatic.
Thyroid Gland: Types of Inflammation
At the heart of thyroid damage, there are several different development mechanisms that are triggered by certain factors. Common to all these pathologies will be the presence of inflammation in the area of the organ. The most popular today is the classification, which takes into account the mechanism of development of pathology and its manifestations. The thyroid gland can be affected as a whole, and only in the area of one lobe or isthmus, part of the lobe. Both acute and chronic thyroiditis can occur, and the inflammation itself against the background of the acute process has both aseptic and purulent character. Most often, the thyroid gland suffers from autoimmune lesions associated with reactions of its own immunity against gland tissue due to violations of biological barriers that shield the body from the immune system.
Causes of inflammation
In addition to an autoimmune lesion, which needs to be discussed separately, acute thyroiditis can form against infections of microbial origin – sepsis or pneumonia, less often lesions of ENT organs. Pathogens are usually introduced into the thyroid gland with a blood stream. Aseptic acute inflammation is possible against a background of trauma, radiation damage to the gland, or hemorrhage.
Subacute thyroiditis occurs as a result of viral inflammation against the background of infection by pathogens such as influenza, measles, mumps or adenovirus. More often women of young and middle age suffer from this disease. Changes in the gland occur after a certain time after infection (from 6-8 weeks). Unlike autoimmune, such inflammation is prone to reverse development without irreversible changes. Chronic inflammation with fibrosis is prone to patients who underwent surgery, suffering from goiter or with a genetic predisposition, allergies and with diabetes.
The role of immunity in thyroiditis Hashimoto
Hashimoto’s thyroiditis, which has an autoimmune nature, becomes a frequent inflammatory pathology of the gland. The process of inflammation occurs as a result of an attack of one’s own immunity on organ tissues; antibodies are synthesized against receptors on thyrocytes. The formation of antigen-antibody complexes on the surface of the glandular tissue triggers a chain of inflammatory reactions with a gradual suppression of the activity of the hormone producing organ. The exact mechanism by which the immune system activates against its own gland is not clear, but there are a number of symptoms by which pathology can be determined. These include a slight increase in the size of the gland, which does not give soreness, as well as a sensation of a coma in the throat and unpleasant bursting when swallowing food. less often, more significant tissue growths with compression of the larynx and pharynx may occur, which forms a cough and hoarseness of the voice. Due to immunity reactions against the gland, with this thyroiditis, hypothyroidism develops, which leads to the need for constant replacement hormone therapy in tablets.
Hypothyroidism on the background of subacute thyroiditis
Often after viral infections, a few weeks later, a thyroid lesion with subacute inflammation is detected. Against it, a suppression of the activity of the gland, hypothyroidism, can gradually form . Symptoms in the initial stage are very minor – a state of weakness with fatigue and pain in the neck, which can give off to the jaw or ear. Hypothyroidism against the background of this process is relatively moderate, as the inflammation resolves, the gland’s hormone production functions are gradually restored. The basis of treatment is the use of non-steroidal anti-inflammatory drugs, in rare cases, hormones, against which the inflammation quickly passes.
Hormone changes in postpartum thyroiditis
After childbirth, some women may form a special form of thyroiditis – lymphocytic (it is also called asymptomatic). Against this background, the thyroid gland increases in size, the synthesis of hormones changes, usually first in the direction of hyperfunction with the subsequent transition to hypothyroidism. On palpation, such an enlarged gland does not give pain, does not bring any discomfort to a woman, only in the blood, according to laboratory tests, hormones change, but against the background of the postpartum period and frequent fatigue, the symptoms of hormonal profile fluctuations may remain unrecognized.
A similar process independently takes place in young mothers, even without any treatment, only under the supervision of a specialist, but can lead to chronic hypothyroidism in about 3% of women after two to three years. In these cases, the only way to correct the condition will be hormones in tablets, which will need to be used for life.
Chronic thyroiditis with tissue fibrosis
A long ongoing inflammatory process in the thyroid gland often leads to the gradual replacement of functional glandular tissue with dense fibrous strands that are not able to participate in the synthesis of hormones. In the early stages, such thyroiditis can produce minor symptoms in the form of a lump in the throat and difficulty swallowing, and as the process progresses, ventilation disorders and speech problems, difficulty swallowing, and hoarseness in the voice may develop. Food intake may suffer due to structural changes in the neck.
When probing the gland, its tuberosity with areas of strong compaction, the immobility of the tissues when swallowing is determined, but all these changes are not painful. The gland is usually affected throughout the area, and its activity gradually suffers with the outcome in a clinically pronounced state of hypothyroidism.