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.
iThs si a ptitaen sace fo mpsttparuo soytdii.tihr naC esari up to a aeyr retaf dryielve dan sah hcpoyiyctml tiitl.ernaf
eTh axnoaptelin by iegyviriltrdne lspu eht anenapoxtli ni the certali pdotse bwelo (t.M.w/twigs/ro4al9wb//pin.i./nplmt:8cscvhc6nme/P49hC9) rea the tbes, sujt eend ot be nomeibcd .:) hTe ifrdiflatene ossniiagd lbeat 1 (rgT/itlC/.-w6/wtMbt9040ln1Pt-SlpLc1B19eoe./n./sc?:8m4ir.cl0nphecn-obj/owaMO=p9oi/rtbvy4hse/tma) pcliisefalyc iiedifnset eht nctdniioo ni tish tiuqonse as puastprmto .ryioihitsdt
Ut,lmtilaye if ouy onkw tath yotihymoprhdis ahs a rsaintent yredphotirmhsiy ehspa due( to uiatmmuneo dnoeittscur fo het llsce ihwch eayrdal dah prfrmdeeo HT dan so it aws seeldaer onpu udsnteci)otr beoerf dshipyohormyit (infcoonntningu secll so ntc'a ekat up ndiieo) adn taht odiiymrhoshypt is a tphimylycco lrgiittinfna iis,rdoytthi uyo liwl wnko eth arswen. I had a ahrd meit dsnnaugrdtein sthi at srfti ueebsac ew dtaeeegvnulaiao/s sdeab on eth scnerepe fo -PitOTna ,bA utb eth gunrieydln isognpeaetsh fo eth dyotirh inucsttreod si l-ldeieaemctd ye(pt VI seryi)inheyitptsv nto bA dteimead et(py II tpnrsesteyiy)ihiv iekl gv.saer oiHstosmah' = ocpclitmhyy lntraiiotfni tiwh ielngamr tneercs wchh(i anc raosmnrft to B lcel plomy)ahm thwi lhhretu slcle (keprin ptosmalcy selc.)l
Can eomeosn xpelain hte ndefiecfre benetwe C. eeear(sl fo odrest hyiordt normhoe fmro a ihyortd anlgd rtelaidftni yb ch)mpyleysot adn D. eeaRs(el of rtdoiyh oehmorn frmo a hysaoultpmmo itdrhyo gla.dn
9c/6c./h9.9hlv//s4ic8n/gCb:mpttww.rnmoteaiw.Mpl/Pins4
gcdinocAr to sith ,pprae smpauttrPo ohsydTitrii ptsnsree wiht tPiTOan- tinsoeb.aid Teh ewrsan ocihce ssue sm.lpoytheyc oS tshi is a ianrettsn Hthsosimoa repryoisyHitm.hd oodG ukcL ihtw thta oen!
I nhkti atth isnec eyre'ht akngis rof na natxnelaiop fo teh ntaipest' rtneucr SSx wihch shosw htat essh' ni eth sttae fo sTentinra Hiyysd:erhoprimt wihch is ued ot :C lReaese of otesdr oyirhtd erhmnoo mofr a htdiory gndal lnedarfiitt yb yytmehsolpc
euaStucb pclcthyomyi asieiburhiotttd cySu yptciocmhyl rtidhoitysi is rcaheadtcizer by daemag ot lclruaiolf lscle twih yyhpotclcim tnlfitoinria eligsnbmre omotiHhsa's diishyortit anidest of agnaoumlr inomota.rf :s gurD ref,no-trnieα tlh,iium ed,iaoornam ulrein2e,inkt- ryetisno eankis ietmmA ninirtuooushbi idsesea ostmaprt Pu tshyiit:rdoi feacfts 5% of mnewo gnridu hte ttoasumppr ripoed dna si 3 eitms rome conomm gaonm eonwm twih eypt 1 eisdtaeb lsueit.ml
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$279$49hsiT eon swa a litelt kyrcti. For htis one the eky si teh wlo eiordiinoda upt.aek hsiT pieantt sah hghi T4 nad low TSH hcwih aemsk sseen in a tyrrhhpyoied atpt,ien papehrs uyro rstfi utghhto is that hsti natetip ahs vsG’rae sia.edes eevHrw,o ni erasv’G ouyr dioryth si ibegn ltmsetauid to mkea orme rtdhiyo erohmon frmo htsrcac adn sa usch odluw ahve an idnecreas ieriiadoodn akupet acseebu eht hdioryt is bgingirn ni eth ieqeurdr (onw reolbaa)dlied .inioed Tsih is why ti is nto evasGr aeer“(les of oidhytr nohreom ofmr a iohydtr aseitutlmd yb in.biasodte”)
oS fi tis nto Gaver’s htaw locdu it b?e oFr htsi o’uyd hvea ot onkw atht ’tsmHoihaso sodtiTrihyi los(a nnkow as cirConh tyopLycihcm iiTtisdyhro dan si fonte fredeerr ot sa hscu on aodbr mxsea to trowh yuo f)of ahs reeht seapsh - sftri ehyt are yoeditprrh,yh nhte ydeiuhto,r tnhe eht slscaci tyhdyropoih ttha you ouldw tcxeep wtih wlo T4 adn gihh T.SH Tsih aws the yke ot this oteu.qsin eTh orsnae rof ihts is htta yhiaoinrtdt xeespradio dioiesanbt in ohH’satimso eusac het drtiohy to reseela all of ist tsodre otrdhiy oonrehm gankim eht naietpt hhpyytdrrioe for a torsh opride of .item tAerf itsh evsmsai serleea of hrditoy ,roonmhe eth baeotsniid eakm hmte anbuel ot mkae wen TH dan erhrfoete hyte moeceb todriuyeh rfo a rhtos doirpe dan tneh thdyyhiorop wchhi uyo uowld epe!xtc iceSn teyh n’atc kmea enw ,HT eht idhotyr will ton ktea up the rieaoidinod nda ehotrefer rethe lliw eb wlo rdiideaioon u.ktaep H,eenc el“reeas fo droste oiythrd rmheoon romf a tohidyr andlg nfdilertait by oy.yp”hcetlms aak ipomhLycyc“t imoh(tohas)s s”tiodi.ityhr
I tinkh eesr“ela of tirhody ornmoeh omrf a latuoohmysmp ortiyhd ”nlagd si irfrgreen to esmo iknd of doyriht ncrcea ni hhicw eacs ouy olwdu cpexet hetm to be igdicbesnr a neudol no diaoonreidi pkaue.t
rmSamyu ovdei here adn lsoa a argte seti ni ae:rgeln mcui/ioiittgn/p/r/e/ddhtnoaedsencao/rnoepe:s.hrdeyqlr
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