Majority of patients equipped age group of 12 to 25 years at a out patient clinic on your Department of Endocrine Tecnicalities, Government General Hospital, Chennai ( a tertiary Care Medical center in South India) are suffering from Thyroiditis. Most of these users seek medical aid if they develop a diffuse goiter. Some of them struggling with palpitation and tremors without thyromegaly but most patients presented with soften goiter in Hypothyroid mention.
Investigations done to look into the diagnosis: (1) FT3, FT4, TSH (2)Thyroid antibodies: Antimicrosomal antibody (TPO) moreover Anti thyroglobulin antibody(ATG) combined with (3) Fine Needle Faith Cytology
Thyroiditis is confirmed judging by positive Antimicrosomal Antibody titre (AMA). All Thyroiditis patients with diffuse goitre had elevated fillers TSH with decreased FT3 & FT4 confirming Hypothyroid status. Hence, they were all treated with thryoxine 50 regarding any 100mcg OD. Patients who presented with palpitation and tremors delivered elevated FT3 & FT4 associated with decreased TSH confirming that they were in the toxic key phrase of thyroiditis. Hence, those patients were treated with beta blocker propranolol.
AntiThyroglobulin antibody titre has been utilized to differentiate Toxic fighting of thyroiditis from Graves' disease. Toxic phase of thyroiditis is due to increased liberation of stored hormone in to the system, due to follicular damage and never have to due to increased production of thyroid hormone. Patients in toxic fighting of thyroiditis developed severe hypothyroidism when treated with antithyroid drug carbimazole for a few weeks.
FNAC is an extremely useful investigation to confirm Thyroiditis. Cytology revealed Lymphocytic infiltration in all patients with thyroidtis.
AMA(TPO) titre became negative in all of our patients over a period of 12 to 18 years. Hence the treatment was given for a similar period. Negative AMA(TPO) titre is an indication to withdraw the health treatment.
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