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Hashimoto's Thyroiditis

Autoimmune hypothyroidism in women that leads to goitre formation.

Sometimes called Hashimoto's Disease, this is part of the spectrum of auto-immune diseases and is related to Graves' disease, lymphocytic thyroiditis as well as other organ related auto-immune conditions such as Addison's disease, diabetes, premature menopause and vitiligo.

Hashimoto's is a lymphocytic and plasmacytic thyroid inflammation that eventually destroys the thyroid.

Clinical suspicion

The gland is firm by palpation. Patients may undergo an initial phase of thyrotoxicosis (Hashitoxicosis) but eventually are rendered either euthyroid or hypothyroid. Microsomal antibodies indicate the autoimmune nature of the disease.

Diagnosis

Thyroid autoantibodies are frequently present:

  • antithyroid peroxidase antibody
  • antithyroglobulin antibody

Thyroid antibodies present in 95% of patients with Hashimoto's thyroiditis make it possible to diagnose this disease without surgery or biopsy. A biopsy from the gland may in some cases be needed to confirm the diagnosis.

Treatment

Patients require permanent thyroid replacement. Rarely, surgery may be needed if the thyroid gland gets too big.

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