Classification of Mandac et al for Interferon Alpha Induced Thyroiditis (IIT)

Description

Mandac et al developed a classification for interferon alpha-induced thyroiditis (IIT). This can help guide patient assessment. The authors are from the Cincinnati VA Medical Center, University of Cincinnati, and Mount Sinai School of Medicine in New York City.

Parameters:

(1) presence of autoantibodies

(2) clinical findings

(3) other features

Autoantibodies	Clinical Findings	Other Findings	Diagnosis
present	none	TSH normal	thyroid antibodies positive
present	hypothyroidism	with or without goiter	Hashimoto's thyroiditis
present	thyrotoxicosis	with or without ophthalmopathy; with or without goiter; diffusely increased uptake on thyroid scan	Grave's disease
absent; negative for TSH-receptor antibodies	thyrotoxicosis initially, followed by transient or permanent hypothyroidism	significantly reduced radioiodine uptake	destructive thyroiditis
absent	hypothyroidism	TSH elevated	non-autoimmune hypothyroidism

where:

• Autoantibodies may include thyroid peroxidase antibodies, thyroglobulin antibodies and TSH-receptor (TSHR) antibodies.

Thyroid hormone replacement is indicated if the patient is hypothyroid.

In destructive thyroiditis beta-blockers may be indicated if symptomatic during the hyperthyroid phase.

In Grave's disease therapy may include:

(1) surgery

(2) radioactive iodine ablation

(3) anti-thyroid medications

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Description

Specialty

ICD-10