Hashimoto's thyroiditis: Difference between revisions

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''Synonyms and Related Keywords:'' Chronic lymphocytic thyroiditis; autoimmune thyroiditis; struma lymphomatosa
''Synonyms and Related Keywords:'' Chronic lymphocytic thyroiditis; autoimmune thyroiditis; struma lymphomatosa
== Natural History, Complications and Prognosis==
If untreated for an extended period, Hashimoto's thyroiditis may lead to muscle failure, including possible heart failure.


== Diagnosis ==  
== Diagnosis ==  

Revision as of 15:54, 19 September 2012

Hashimoto's thyroiditis
Histology
ICD-10 E06.3
ICD-9 245.2
OMIM 140300
DiseasesDB 5649
MeSH D050031

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Case #1

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]

Synonyms and Related Keywords: Chronic lymphocytic thyroiditis; autoimmune thyroiditis; struma lymphomatosa

Diagnosis

Symptoms

In many cases, Hashimoto's thyroiditis usually results in hypothyroidism, although in its acute phase, it can cause a transient hyperthyroidism thyrotoxic state known as hashitoxicosis.

  • Adolescent goiter
  • Alternating hypo- and hyperthyroidism
  • Euthyroidism and goiter
  • Hypothyroidism
  • Painless thyroiditis or silent thyroiditis
  • Postpartum painless thyrotoxicosis
  • Primary thyroid failure
  • Subclinical hypothyroidism and goiter

(In alphabetical order) [1]

Other symptoms that can occur with this disease:

  • Joint stiffness
  • Swelling of the face

Physical Examination

Appearance of the Patient

Vital Signs

Skin

Head

  • Puffy face

Throat

  • Enlarged neck or presence of goiter
  • Small or shrunken thyroid gland (late in the disease

Neurologic

  • Slowed speech
  • Slowed reflexes

Laboratory Findings

Electrolyte and Biomarker Studies

  • Thyroid-stimulating hormone (TSH)
  • Free T3 and Free T4
  • Anti-thyroglobulin antibodies (anti-Tg)
  • Anti-thyroid peroxidase antibodies (anti-TPO)
  • Anti-microsomal antibodies can help obtain an accurate diagnosis.[2] Earlier assessment of the patient may present with elevated levels of thyroglobulin owing to the transient thyrotoxicosis as inflammation within the thyroid causes damage to the integrity of thyroid follicle storage of thyroglobulin; TSH is concomitantly decreased.[3]
  • Diagnosis is made by detecting elevated levels of Anti-TPO antibodies in the serum.

Treatment

Pharmacotherapy

Chronic Pharmacotherapies

Hypothyroidism caused by Hashimoto's Thyroiditis is treated with thyroid hormone replacement. A small pill taken once a day should be able to keep the thyroid hormone levels normal. This medicine will, in most cases, need to be taken for the rest of the patient's life.

Case Studies

Case#1

References

  1. Ladenson P, Kim M. Thyroid. In: Goldman L and Ausiello D, eds. Goldman: Cecil Medicine. 23rd ed. Philadelphia, Pa:Saunders; 2007:chap 244.
  2. Giannini, AJ (1986). The Biological Foundations of Clinical Psychiatry. New Hyde Park, NY: Medical Examination Publishing Company. pp. 193–198. ISBN 0-87488-449-7.
  3. Simmons, PJ (1998). "Antigen-presenting dendritic cells as regulators of the growth of thyrocytes: a role of interleukin-1beta and interleukin-6". Endocrinology. 139 (7): 3158–3186. doi:10.1210/en.139.7.3148. PMID 9645688. Unknown parameter |month= ignored (help); Unknown parameter |coauthors= ignored (help)

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