Differential Diagnoses for Acquired Hypothyroidism
Single Most Likely Diagnosis
- Autoimmune thyroiditis (Hashimoto's thyroiditis): This is the most common cause of acquired hypothyroidism, especially in women. It is characterized by autoimmune destruction of the thyroid gland, leading to a decrease in thyroid hormone production.
Other Likely Diagnoses
- Iatrogenic hypothyroidism: This occurs after surgical removal of part or all of the thyroid gland or after radioactive iodine treatment for hyperthyroidism. It is a common cause of hypothyroidism, especially in patients with a history of thyroid surgery or radioactive iodine therapy.
- Radiation-induced hypothyroidism: Exposure to radiation, especially in the neck area, can damage the thyroid gland and lead to hypothyroidism. This is often seen in patients who have undergone radiation therapy for cancer.
- Thyroid gland destruction due to infiltrative diseases: Certain diseases, such as amyloidosis or sarcoidosis, can infiltrate the thyroid gland and cause hypothyroidism.
Do Not Miss Diagnoses
- Pituitary or hypothalamic disease: Although less common, diseases affecting the pituitary or hypothalamus, such as tumors or infiltrative diseases, can lead to central hypothyroidism. Missing these diagnoses can have significant consequences, as they may require specific treatment.
- Medication-induced hypothyroidism: Certain medications, such as lithium or amiodarone, can cause hypothyroidism. Recognizing these causes is crucial, as discontinuing the offending medication may reverse the hypothyroidism.
Rare Diagnoses
- Infectious thyroiditis: Rarely, infections such as subacute granulomatous thyroiditis or suppurative thyroiditis can cause hypothyroidism.
- Congenital thyroid dysgenesis: Although typically diagnosed at birth, some cases of congenital thyroid dysgenesis may not be detected until later in life, leading to acquired hypothyroidism.
- Thyroid gland destruction due to trauma: Trauma to the neck can damage the thyroid gland and lead to hypothyroidism, although this is a rare cause.