This is definitely not Reidel's thyroiditis. I remember getting a question wrong on UW, in regard to subacute granulomatous de quervain's thyroiditis. The pathogenesis is granulomatous inflammation destroying the thyroid follicles and releasing stored T4/T3, with a LOW radioiodine uptake. I think this line is super important to get the diagnosis right. Like liverdietrying mentioned, you need to understand that in thyroiditis of basically any cause (postpartum, hashimotos, subacute), there is a release of thyroid hormones leading to a transient hyperthyroid state which then BECOMES hypothyroid later after a brief euthyroid phase. Hence the term thyroiditis, inflammation of the thyroid gland, with release of it's contents.
Tshi si a ptneita csea of atmstppour rsthiido.iyt aCn esiar pu ot a reay traef rldeieyv nad ash yopilcytchm nfiietal.tr
Teh alxeiptnaon yb ediryilevtginr lsup hte xtpinloeaan in het tcrleai oetdsp lwobe (ww89Co/c//t/mnh/ivb4n:.spptte6rMilc.9cgPamn/4sli9w.h.) era the t,bes sjut deen ot be codenibm ).: heT ffreadtlneii siangiods lbaet 1 (Cta94otw/c1P0=4B.rb4bcm-./99eih-eov/OL1e.o/a6opStirrwh/lltwln/sM-0.ty?Ticm/p/ng0Mnej:cpn1tsb8l) yiclialfespc efiinsited hte nntiiocod ni htis uqesiton sa ttopupsram yiihs.rtodti
emtt,aylliU if yuo kwon htta htdooyprysiimh sah a ettnrinsa mshorehryipdtyi asehp (due ot mouatiuemn dustentirco fo het lcsle hcihw adelyra adh mdefoerrp HT dan so it asw seedalre npuo odtetncr)isu efbroe hhstporimoyiyd (nncougfinonnti sclle os 'tcan etka up )ideion adn ahtt mriihosphoyydt is a moyhctcpyli tgfainirlint drtiyhoitis, yuo lilw nowk the was.enr I dha a hdra meti utrgdniednsan itsh ta ftisr cebuase ew l/doateaivuesngae sdbae on teh persenec fo t-inPaOT bA, tub hte nyrligneud peogisesnhta fo eth irotdhy usrteoicntd si dimcatd-eleel (type VI ptnyityv)hieerssi ont bA idaedmte (ypet II neh)reisypiysitvt leki rsagv.e soiomthsaH' = cyyhiomplct tnfoanitilir ithw gnelarmi nsetrce hwihc( nac aonstmrfr ot B cell lmpamyo)h whit uethrlh escll rpnike( mspolacty elc).ls
Cna eonsmeo xalpnei hte iefdrnecef ewntebe .C (reeelsa fo orsedt ithrdoy omeorhn from a ityodrh ndagl riaidtfnelt yb yyhclopt)sem dan D. slae(eRe of idthoyr omohner rmfo a utamhlspomyo hrtyido ndgl.a
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cingoAdcr to thsi ,praep tsarmoptuP siodhTyrtii peetssnr htwi P-aOiTnt tbaos.iedni Teh arsnew icoehc usse ytolecyspmh. So this is a rttinnesa sHoahstimo eytymd.Hihpirors oGod cuLk wthi atht eo!n
I kthni tath cneis ehr'tye gniksa rof na aleinantpxo of eth ts'itnepa nturerc SSx whhic wsosh that ses'h ni the steat fo rTsnnieat rdhpeiioHsrm:yyt cihhw is deu ot :C eeRsela fo etsdor dytorhi morneoh fomr a ydohtri dalng lrtteandfii yb pmsloehtycy
Stacueub occphltyimy cSoaruiui tdthbyetsi hmtolpiyccy hirsoiyttdi si ezceciahatrdr yb edamag to frocilalul ellsc hitw otycicphmyl annrtiitliof legbermnis mssHoth'oai ihtodtysrii anseidt of ogualmnar tmfonriao. r:su Dg t,eroαif-nrne ihumlt,i oimerdnao,a e2ie,nlrk-iunt syoetrin kniase smimtthuiorbienouAn i eiesasd pPutr matso th:iiystrdio tcffsea 5% fo wnmeo urdnig eth rouamtstpp rpeodi nad is 3 tmsei omer mncoom ngmoa oemwn whit tepy 1 biadeste .timulels
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$279$49ihTs oen was a ilttel tyrik.c oFr sthi one eth yek si eht lwo iidorniaedo tp.euka Tish ittnape sah ihhg 4T dan lwo HTS wihch kseam nssee in a ohtyyrrdhepi ntet,api rseppah uyro ifsrt thhugot si ahtt shit atpetni ash Gsvera’ eids.sae ,overewH ni srG’ave uyor ohtdiyr is enigb ldiattmesu ot kaem erom yhtidor omnohre rmfo tsccrah adn as such oduwl veah an drenicase eodorndiaii ktupae scabeeu eht oihtryd si rgingbni ni teh idqrereu won( bd)eilodarale edin.oi isTh si why ti si not esvGar ese(“elar fo throdyi meroohn mrfo a toiyrdh asmditlute yb te)iiobsad.n”
oS fi its tno Grvaes’ hwat dlouc ti ?eb orF tihs ’ouyd evha to wkno ttah sHasooti’mh iyTdsoihtir (slao wnkon sa oicnrhC icpoycmhLyt ytioiTshrid dan si eotnf reefedrr ot as schu no rdbao msaxe ot othwr you ff)o sha ehert psashe - frsit yeth rae yetihr,hyrodp neth ,rtdoehyui then teh asslcic yhythiodpro hatt uyo dluwo xeptec with olw 4T nda hghi .TSH Thsi swa eth eyk to shti .tionuesq Teh onrsea ofr itsh is that tntoriyhida reidxapeos eatdiobsni ni s’Hioatsmho eusca eht doihyrt to seaerle lal fo sti oderts dyritho nomerho mkigan eth eattinp priothdryhye fro a thosr idepor of imt.e Atrfe hits aivsmes erelaes of iyohrtd reoh,onm the tendasobii kaem ethm uanble ot meak wen TH dna rrohteefe they eecmob oirdyethu for a hstor epodri nad hnet hhoroitdypy hhciw yuo wuldo ptcee!x Sienc hyet at’cn emak wen ,TH teh ryditho llwi ont eatk up eth idoornidiea dna feeortehr rheet wlil eb lwo aiieodoindr taup.ke neceH, eal“esre of destro tihdyor rnhomoe ofmr a thdrioy lngad tladniifret yb o”pehc.stmlyy aka hmiycLocyt“p )thsomo(isha titsdh.yr”iio
I thkin “aseeelr of irodyth nrhoemo rmfo a lmaompyhotsu irhdyot dnag”l is rrfreegin to oems nkid fo hoirytd anecrc in wichh ecas you udwol etpxce thme ot be ibiecrnsgd a enuold on nidadirioeo auktp.e
mmSyura vedoi eerh nda olas a rgtea iste in rle:eagn poacradlpcdinsirroey/nighse/h/te/roim:toqet/ued/denn.
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