Vol. 12. Núm. 13.
Páginas 742-753 (Junio 2016)

Actualización
Tiroiditis

Thyroiditis

J.C. GalofréabJ. PinedabcM. TonibdE. Andabc
Doi : https://10.1016/j.med.2016.06.004
Opciones
Resumen
Introducción

Las tiroiditis, o inflamación de la glándula tiroides, comprenden una serie de trastornos con diverso origen y duración.

 Etiopatogenia, clasificación y curso clínico

La tiroiditis aguda (o piógena) es rara y suele estar causada por agentes bacterianos. La función tiroidea no suele alterarse. La tiroiditis subaguda más frecuente es la de De Quervain. Es un proceso autolimitado que comienza con la presencia de un dolor importante en la cara anterior del cuello. El curso clínico es bimodal: inicialmente suelen tener una fase de tirotoxicosis y posteriormente una fase hipotiroidea. Otras tiroiditis subagudas son la tiroiditis silente y la tiroiditis posparto. Ambas se consideran de origen autoinmune y se diferencian de la anterior en que son indoloras. La tiroiditis crónica por excelencia es la de Hashimoto. Tiene un origen autoinmune y evoluciona hacia un hipotiroidismo permanente. Entre las tiroiditis menos comunes destacan las tiroiditis inducidas por fármacos y la tiroiditis de Riedel que es extraordinariamente infrecuente.

 Pronóstico y tratamiento

El tratamiento depende de la etiología, pero generalmente tienen un curso benigno.

Palabras clave
Tiroiditis
Hashimoto
Subaguda
Tirotoxicosis
Abstract
Introduction

The term thyroiditis encompasses some relatively common inflammatory disorders of the thyroid gland, which have been classified according to their aetiology and course length.

 Etiopathogeny, classification and clinical course

Infectious agents cause acute suppurative thyroiditis, an unusual disorder that does not generate thyroid dysfunction. De Quervain's thyroiditis is the most common subacute thyroiditis. It is a self-limited process that is typically presented with a sharp pain in the anterior neck. The clinical course is bimodal: usually starts with a thyrotoxic period followed by a hypothyroid phase and eventually return to a euthyroid state. Others subacute thyroiditis are postpartum and silent thyroiditis. Both of them are painless temporary conditions of an autoimmune origin. Hashimoto's thyroiditis is the most representative of chronic thyroiditis. It has an autoimmune origin and normally progresses to a permanent hypothyroidism. Uncommon thyroiditis includes drug-related thyroiditis and the exceedingly rare Riedel's thyroiditis.

 Prognosis and treatment

The treatment relies on the aetiology, but thyroiditis generally have a benign course.

Keywords
Thyroiditis
Hashimoto
Subacute
Thyrotoxicosis

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