Updated: 11/13/2019

Hashimoto Thyroiditis

0%
Topic
Review Topic
0
0
N/A
N/A
Questions
2 2
0
0
0%
0%
Evidence
2 2
0
0
Introduction
  • hashimotosA condition characterized by the autoimmune destruction of the thyroid
  • Pathophysiology 
    • the inflammatory reaction is a combination type II and type IV hypersensitivity reaction
      • type II hypersensitivity reaction
        • anti-TSH receptor antibodies are formed that inhibit thyroid hormone release
          • opposite of Grave's disease
        • anti-microsomal and anti-thyroglobulin antibodies are formed that lead to destruction of thyroid stroma 
          • do not confuse with anti-mitochondrial in primary biliary sclerosis
      • type IV hypersensitivity reaction
        • CD8 cells directly destroy thyroid tissue
        • CD4-attracted macrophages destroy thyroid tissue
  • Genetics
    • association with HLA-DR3, DR5 genotype
  • Associated conditions
    • chromosomal aneuploidies
Presentation
  • Symptoms
    • hyperthyroidism
      • seen early in the disease course
      • consequence of thryoid tissue destruction which releases stored thyroid hormones
    • hypothyroidism 
      • seen later in the disease course
      • after pre-formed thyroid hormone stores are released there is a decreased release as a result of impaired production
  • Physical exam
    • moderately enlarged, non-tender gland
Evaluation
  • Histology
    • lymphocytic infiltrate
    • germinal follicles
    • Hürthle cells (eosinophilic-staining cells)
    • fibrosis
Treatment
  •  Pharmacologic
    • thyroid hormone supplementation
Complications
  • Primary B-cell lymphoma of thyroid
    • increased risk of primary B-cell lymphoma of thyroid
 

Please rate topic.

Average 4.8 of 8 Ratings

Questions (2)
Question locked
Sorry, this question is for
PEAK Premium Subscribers only
Upgrade to PEAK
Question locked
Sorry, this question is for
PEAK Premium Subscribers only
Upgrade to PEAK
Evidence (2)
Topic COMMENTS (11)
Private Note