This form of thyroiditis is dominated by the pathological picture of a prominent lymphocytic infiltration of the gland. The evidence to date suggests that silent thyroiditis is a variant of lymphocytic thyroiditis. Both have a predilection to occur in the post-partum period but are also common in the non-pregnant state. In contrast to subacute thyroiditis, the clinical features are usually (but not invariably) milder. There is usually less or no pain in the cervical region and less or no thyroid tenderness, despite, at times, acute enlargement of the thyroid. There are minimal if any systemic symptoms and the thyrotoxic symptoms, if present, may be quite mild. The subsequent evolution in the thyroid biochemical abnormalities has a similar clinical course to that of subacute thyroiditis. However, in contrast to subacute thyroiditis, patients with silent thyroiditis often have recurrences and up to one-half of the patients may develop permanent hypothyroidism in the future.
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