Skip to main content
SpringerLink
Log in
Book cover

Surgical Endocrinopathies pp 25–33Cite as

Hyperthyroidism and Thyroiditis

  • Chapter
  • First Online:

  • 910 Accesses

Abstract

Causes of hyperthyroidism and the different entities involved with thyroiditis compose the majority of benign endocrine diseases. These disorders range from the very common chronic lymphocytic thyroiditis (Hashimoto’s thyroiditis) and Graves’ disease to the very rare invasive fibrous thyroiditis (Riedel’s thyroiditis). Their presentation is just as diverse, anywhere from an incidental goiter to a life-threatening thyrotoxicosis. This chapter focuses on the evaluation, diagnosis, and management of hyperthyroidism and the various types of thyroiditis, with special attention to laboratory studies, radiologic findings, pathology, and surgical management.

This is a preview of subscription content, log in via an institution.

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   149.00
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD   109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

References

  1. Campbell AJ. Thyroid disorders in the elderly. Difficulties in diagnosis and treatment. Drugs. 1986;31(5):455–61.

    Article  CAS  PubMed  Google Scholar 

  2. Vanderpump MP, et al. The incidence of thyroid disorders in the community: a twenty-year follow-up of the Whickham Survey. Clin Endocrinol (Oxf). 1995;43(1):55–68.

    Article  CAS  Google Scholar 

  3. Tunbridge WM, et al. The spectrum of thyroid disease in a community: the Whickham survey. Clin Endocrinol (Oxf). 1977;7(6):481–93.

    Article  CAS  Google Scholar 

  4. Pearce EN, Braverman LE. Hyperthyroidism: advantages and disadvantages of medical therapy. Surg Clin North Am. 2004;84(3):833–47.

    Article  PubMed  Google Scholar 

  5. Baker JR Jr. Immunologic aspects of endocrine diseases. JAMA. 1992;268(20):2899–903.

    Article  PubMed  Google Scholar 

  6. Stenszky V, et al. The genetics of Graves’ disease: HLA and disease susceptibility. J Clin Endocrinol Metab. 1985;61(4):735–40.

    Article  CAS  PubMed  Google Scholar 

  7. McDermott MT, Ridgway EC. Central hyperthyroidism. Endocrinol Metab Clin North Am. 1998;27(1):187–203.

    Article  CAS  PubMed  Google Scholar 

  8. Ralls PW, et al. Color-flow Doppler sonography in Graves disease: “thyroid inferno”. AJR Am J Roentgenol. 1988;150(4):781–4.

    Article  CAS  PubMed  Google Scholar 

  9. Chopra IJ. A study of extrathyroidal conversion of thyroxine (T4) to 3,3’,5-triiodothyronine (T3) in vitro. Endocrinology. 1977;101(2):453–63.

    Article  CAS  PubMed  Google Scholar 

  10. Cooper DS. Antithyroid drugs. N Engl J Med. 1984;311(21):1353–62.

    Article  CAS  PubMed  Google Scholar 

  11. Cooper DS, et al. Agranulocytosis associated with antithyroid drugs. Effects of patient age and drug dose. Ann Intern Med. 1983;98(1):26–9.

    Article  CAS  PubMed  Google Scholar 

  12. Graham GD, Burman KD. Radioiodine treatment of Graves’ disease. An assessment of its potential risks. Ann Intern Med. 1986;105(6):900–5.

    Article  CAS  PubMed  Google Scholar 

  13. Saenger EL, Thoma GE, Tompkins EA., Incidence of leukemia following treatment of hyperthyroidism. Preliminary report of the cooperative thyrotoxicosis therapy follow-up study. JAMA. 1968;205(12):855–62.

    Article  CAS  PubMed  Google Scholar 

  14. Ron E, et al. Cancer mortality following treatment for adult hyperthyroidism. Cooperative thyrotoxicosis therapy follow-up study group. JAMA. 1998;280(4):347–55.

    Article  CAS  PubMed  Google Scholar 

  15. Dobyns BM, et al. Malignant and benign neoplasms of the thyroid in patients treated for hyperthyroidism: a report of the cooperative thyrotoxicosis therapy follow-up study. J Clin Endocrinol Metab. 1974;38(6):976–98.

    Article  CAS  PubMed  Google Scholar 

  16. Safa AM, Schumacher OP, Rodriguez-Antunez A. Long-term follow-up results in children and adolescents treated with radioactive iodine (131I) for hyperthyroidism. N Engl J Med. 1975;292(4):167–71.

    Article  CAS  PubMed  Google Scholar 

  17. Fujii H. A long-term follow-up study of late-onset hypothyroidism and prognosis of hyperthyroid patients treated with radioiodine. Kaku Igaku. 1991;28(9):1067–73.

    CAS  PubMed  Google Scholar 

  18. Liu J, et al. Total thyroidectomy: a safe and effective treatment for Graves’ disease. J Surg Res. 2011;168(1):1–4.

    Article  PubMed Central  PubMed  Google Scholar 

  19. Prasai A, et al. Total thyroidectomy for safe and definitive management of Graves’ disease. J Laryngol Otol. 2013;127(7):681–4.

    Article  CAS  PubMed  Google Scholar 

  20. Carnell NE, Valente WA. Thyroid nodules in Graves’ disease: classification, characterization, and response to treatment. Thyroid. 1998;8(7):571–6.

    Article  CAS  PubMed  Google Scholar 

  21. Ozaki O, et al. Thyroid carcinoma in Graves’ disease. World J Surg. 1990;14(3):437–40, discussion 440–1.

    Article  CAS  PubMed  Google Scholar 

  22. Behar R, et al. Graves’ disease and thyroid cancer. Surgery. 1986;100(6):1121–7.

    CAS  PubMed  Google Scholar 

  23. Falk SA, Birken EA, Ronquillo AH. Graves’ disease associated with histologic Hashimoto’s thyroiditis. Otolaryngol Head Neck Surg. 1985;93(1):86–91.

    CAS  PubMed  Google Scholar 

  24. Gwinup G, Elias AN, Ascher MS. Effect on exophthalmos of various methods of treatment of Graves’ disease. JAMA. 1982;247(15):2135–8.

    Article  CAS  PubMed  Google Scholar 

  25. Marushak D, Faurschou S, Blichert-Toft M. Regression of ophthalmopathy in Graves’ disease following thyroidectomy. A systematic study of changes of ocular signs. Acta Ophthalmol (Copenh). 1984;62(5):767–79.

    Article  CAS  Google Scholar 

  26. Vana S, et al. Surgical treatment of endocrine orbital disease. Indications, methods, results. Vnitr Lek. 1992;38(9):897–902.

    CAS  PubMed  Google Scholar 

  27. Hamburger JI. Evolution of toxicity in solitary nontoxic autonomously functioning thyroid nodules. J Clin Endocrinol Metab. 1980;50(6):1089–93.

    Article  CAS  PubMed  Google Scholar 

  28. Hamburger JI. Solitary autonomously functioning thyroid lesions. Diagnosis, clinical features and pathogenetic considerations. Am J Med. 1975;58(6):740–8.

    Article  CAS  PubMed  Google Scholar 

  29. Russo D, et al. Thyrotropin receptor gene alterations in thyroid hyperfunctioning adenomas. J Clin Endocrinol Metab. 1996;81(4):1548–51.

    CAS  PubMed  Google Scholar 

  30. Russo D, et al. Genetic alterations in thyroid hyperfunctioning adenomas. J Clin Endocrinol Metab. 1995;80(4):1347–51.

    CAS  PubMed  Google Scholar 

  31. Derwahl M, et al. Constitutive activation of the Gs alpha protein-adenylate cyclase pathway may not be sufficient to generate toxic thyroid adenomas. J Clin Endocrinol Metab. 1996;81(5):1898–904.

    CAS  PubMed  Google Scholar 

  32. Arturi F, et al. Thyrotropin receptor mutations and thyroid hyperfunctioning adenomas ten years after their first discovery: unresolved questions. Thyroid. 2003;13(4):341–3.

    Article  CAS  PubMed  Google Scholar 

  33. Walfish PG, Strawbridge HT, Rosen IB. Management implications from routine needle biopsy of hyperfunctioning thyroid nodules. Surgery. 1985;98(6):1179–88.

    CAS  PubMed  Google Scholar 

  34. Monzani F, et al. Five-year follow-up of percutaneous ethanol injection for the treatment of hyperfunctioning thyroid nodules: a study of 117 patients. Clin Endocrinol (Oxf). 1997;46(1):9–15.

    Article  CAS  Google Scholar 

  35. Papini E, et al. Percutaneous ultrasound-guided ethanol injection: a new treatment of toxic autonomously functioning thyroid nodules? J Clin Endocrinol Metab. 1993;76(2):411–6.

    Article  CAS  PubMed  Google Scholar 

  36. Papini E, et al. Long-term results of echographically guided percutaneous ethanol injection in the treatment of the autonomous thyroid nodule. Minerva Endocrinol. 1993;18(4):173–9.

    CAS  PubMed  Google Scholar 

  37. Livraghi T, et al. Treatment of autonomous thyroid nodules with percutaneous ethanol injection: 4-year experience. Radiology. 1994;190(2):529–33.

    Article  CAS  PubMed  Google Scholar 

  38. Baltisberger BL, Minder CE, Burgi H. Decrease of incidence of toxic nodular goitre in a region of Switzerland after full correction of mild iodine deficiency. Eur J Endocrinol. 1995;132(5):546–9.

    Article  CAS  PubMed  Google Scholar 

  39. Vassart G, Dumont JE. The thyrotropin receptor and the regulation of thyrocyte function and growth. Endocr Rev 1992;13(3):596–611.

    CAS  PubMed  Google Scholar 

  40. Dumont JE, et al. Physiological and pathological regulation of thyroid cell proliferation and differentiation by thyrotropin and other factors. Physiol Rev. 1992;72(3):667–97.

    CAS  PubMed  Google Scholar 

  41. Blum M, et al. Thyroid storm after cardiac angiography with iodinated contrast medium. Occurrence in a patient with a previously euthyroid autonomous nodule of the thyroid. JAMA. 1976;235(21):2324–5.

    Article  CAS  PubMed  Google Scholar 

  42. Heimann P. Should hyperthyroidism be treated by surgery? World J Surg. 1978;2(3):281–7.

    Article  CAS  PubMed  Google Scholar 

  43. Huysmans D, et al. Radioiodine for nontoxic multinodular goiter. Thyroid. 1997;7(2):235–9.

    Article  CAS  PubMed  Google Scholar 

  44. Smith JJ, et al. Toxic nodular goiter and cancer: a compelling case for thyroidectomy. Ann Surg Oncol. 2013;20(4):1336–40.

    Article  PubMed  Google Scholar 

  45. Hay ID. Thyroiditis: a clinical update. Mayo Clin Proc. 1985;60(12):836–43.

    Article  CAS  PubMed  Google Scholar 

  46. Volpe R. The pathology of thyroiditis. Hum Pathol. 1978;9(4):429–38.

    Article  CAS  PubMed  Google Scholar 

  47. Intenzo CM, et al. Clinical, laboratory, and scintigraphic manifestations of subacute and chronic thyroiditis. Clin Nucl Med. 1993;18(4):302–6.

    Article  CAS  PubMed  Google Scholar 

  48. Weetman AP, Walport MJ. The association of autoimmune thyroiditis with systemic lupus erythematosus. Br J Rheumatol. 1987;26(5):359–61.

    Article  CAS  PubMed  Google Scholar 

  49. Weetman A. A hundred years of Hashimoto’s thyroiditis. Thyroid. 2013;23(2):135–6.

    Article  PubMed  Google Scholar 

  50. Weetman AP. The immunopathogenesis of chronic autoimmune thyroiditis one century after hashimoto. Eur Thyroid J. 2013;1(4):243–50.

    PubMed Central  PubMed  Google Scholar 

  51. Weetman AP. Autoimmune thyroiditis: predisposition and pathogenesis. Clin Endocrinol (Oxf). 1992;36(4):307–23.

    Article  CAS  Google Scholar 

  52. Tunbridge WM, et al. Natural history of autoimmune thyroiditis. Br Med J (Clin Res Ed). 1981;282(6260):258–62.

    Article  CAS  Google Scholar 

  53. Fatourechi V, McConahey WM, Woolner LB. Hyperthyroidism associated with histologic Hashimoto’s thyroiditis. Mayo Clin Proc. 1971;46(10):682–9.

    CAS  PubMed  Google Scholar 

  54. Hayashi Y, et al. A long term clinical, immunological, and histological follow-up study of patients with goitrous chronic lymphocytic thyroiditis. J Clin Endocrinol Metab. 1985;61(6):1172–8.

    Article  CAS  PubMed  Google Scholar 

  55. Holm LE, Blomgren H, Lowhagen T. Cancer risks in patients with chronic lymphocytic thyroiditis. N Engl J Med. 1985;312(10):601–4.

    Article  CAS  PubMed  Google Scholar 

  56. Kato I, et al. Chronic thyroiditis as a risk factor of B-cell lymphoma in the thyroid gland. Jpn J Cancer Res. 1985;76(11):1085–90.

    CAS  PubMed  Google Scholar 

  57. Farid NR, Hawe BS, Walfish PG. Increased frequency of HLA-DR3 and 5 in the syndromes of painless thyroiditis with transient thyrotoxicosis: evidence for an autoimmune aetiology. Clin Endocrinol (Oxf). 1983;19(6):699–704.

    Article  CAS  Google Scholar 

  58. Inada M, et al. Reversible changes of the histological abnormalities of the thyroid in patients with painless thyroiditis. J Clin Endocrinol Metab. 1981;52(3):431–5.

    Article  CAS  PubMed  Google Scholar 

  59. Mizukami Y, et al. Silent thyroiditis: a histologic and immunohistochemical study. Hum Pathol. 1988;19(4):423–31.

    Article  CAS  PubMed  Google Scholar 

  60. Woolf PD, Thyroiditis. Med Clin North Am. 1985;69(5):1035–48.

    CAS  PubMed  Google Scholar 

  61. Hamburger JI. The various presentations of thyroiditis. Diagnostic considerations. Ann Intern Med. 1986;104(2):219–24.

    Article  CAS  PubMed  Google Scholar 

  62. Singer PA. Thyroiditis. Acute, subacute, and chronic. Med Clin North Am. 1991;75(1):61–77.

    Google Scholar 

  63. Volpe R. Subacute (de Quervain’s) thyroiditis. Clin Endocrinol Metab. 1979;8(1):81–95.

    Article  CAS  PubMed  Google Scholar 

  64. Volpe R. Subacute thyroiditis. Prog Clin Biol Res. 1981;74:115–34.

    CAS  PubMed  Google Scholar 

  65. Volpe R. The management of subacute (DeQuervain’s) thyroiditis. Thyroid. 1993;3(3):253–5.

    Article  CAS  PubMed  Google Scholar 

  66. Volpe R, Row VV, Ezrin C. Circulating viral and thyroid antibodies in subacute thyroiditis. J Clin Endocrinol Metab. 1967;27(9):1275–84.

    Article  CAS  PubMed  Google Scholar 

  67. Stancek D, et al. Isolation and some serological and epidemiological data on the viruses recovered from patients with subacute thyroiditis de Quervain. Med Microbiol Immunol. 1975;161(2):133–44.

    Article  CAS  PubMed  Google Scholar 

  68. Mizukami Y, et al. Immunohistochemical and ultrastructural study of subacute thyroiditis, with special reference to multinucleated giant cells. Hum Pathol. 1987;18(9):929–35.

    Article  CAS  PubMed  Google Scholar 

  69. Mizukami Y, et al. Chronic thyroiditis: thyroid function and histologic correlations in 601 cases. Hum Pathol. 1992;23(9):980–8.

    Article  CAS  PubMed  Google Scholar 

  70. Berger SA, et al. Infectious diseases of the thyroid gland. Rev Infect Dis. 1983;5(1):108–22.

    Article  CAS  PubMed  Google Scholar 

  71. Takai SI, et al. Internal fistula as a route of infection in acute suppurative thyroiditis. Lancet. 1979;1(8119):751–2.

    Article  CAS  PubMed  Google Scholar 

  72. Miyauchi A. Thyroid gland: a new management algorithm for acute suppurative thyroiditis? Nat Rev Endocrinol. 2010;6(8):424–6.

    Article  PubMed  Google Scholar 

  73. Miyauchi A, et al. Piriform sinus fistula: an underlying abnormality common in patients with acute suppurative thyroiditis. World J Surg. 1990;14(3):400–5.

    Article  CAS  PubMed  Google Scholar 

  74. Schwaegerle SM, Bauer TW, Esselstyn CB Jr. Riedel’s thyroiditis. Am J Clin Pathol. 1988;90(6):715–22.

    CAS  PubMed  Google Scholar 

  75. Ozgen A, Cila A. Riedel’s thyroiditis in multifocal fibrosclerosis: CT and MR imaging findings. AJNR Am J Neuroradiol. 2000;21(2):320–1.

    CAS  PubMed  Google Scholar 

  76. Perez Fontan FJ, et al. Riedel thyroiditis: US, CT, and MR evaluation. J Comput Assist Tomogr. 1993;17(2):324–5.

    Article  CAS  PubMed  Google Scholar 

  77. Lorenz K, et al. Riedel’s thyroiditis: impact and strategy of a challenging surgery. Langenbecks Arch Surg. 2007;392(4):405–12.

    Article  PubMed  Google Scholar 

  78. Soh SB, et al. Novel use of rituximab in a case of Riedel’s thyroiditis refractory to glucocorticoids and tamoxifen. J Clin Endocrinol Metab. 2013;98(9):3543–9.

    Article  CAS  PubMed  Google Scholar 

  79. Pritchyk K, et al. Tamoxifen therapy for Riedel’s thyroiditis. Laryngoscope. 2004;114(10):1758–60.

    Article  PubMed  Google Scholar 

  80. Few J, et al. Riedel’s thyroiditis: treatment with tamoxifen. Surgery. 1996;120(6):993–8, discussion 998–9.

    Article  CAS  PubMed  Google Scholar 

  81. Lo JC, et al. Riedel’s thyroiditis presenting with hypothyroidism and hypoparathyroidism: dramatic response to glucocorticoid and thyroxine therapy. Clin Endocrinol (Oxf). 1998;48(6):815–8.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Endocrine Surgery, Surgery, Otoloaryngology and Biochemistry, NYU Langone Medical Center, 530 First Ave., Suite 6H, 10016, New York, NY, USA

    Kepal N. Patel MD

Authors
  1. Kepal N. Patel MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Kepal N. Patel MD .

Editor information

Editors and Affiliations

  1. Divisions of General Surgery and Surgical Oncology, Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada

    Janice L. Pasieka

  2. Department of Surgery, Columbia University Medical Center, New York, New York, USA

    James A. Lee

Rights and permissions

Reprints and permissions

Copyright information

© 2015 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Patel, K. (2015). Hyperthyroidism and Thyroiditis. In: Pasieka, J., Lee, J. (eds) Surgical Endocrinopathies. Springer, Cham. https://doi.org/10.1007/978-3-319-13662-2_5

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-13662-2_5

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-13661-5

  • Online ISBN: 978-3-319-13662-2

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation