Hashimoto's thyroiditis. Hashimoto's thyroiditis is an autoimmune disease that is characterized by the destruction of the thyroid gland, the name of the disease comes from the Japanese doctor Hashimoto who made the first description in the year 1912 and described it as a lymphomatous goiter, it is also known such as chronic lymphocytic thyroiditis , thyroiditis or inflammation of the thyroid gland, lymphocytic because histologically diffuse lymphocytic infiltration is observed and according to its chronology it is considered chronic. Etiology: the cause of hashimoto's thyroiditis is autoimmune, it means that the body itself attacks the cells of the thyroid gland that is why it is known as autoimmune thyroiditis. Hashimoto's thyroiditis is more common in women with a ratio of approximately 10 to 1 compared to men. At what age can hashimoto's thyroiditis appear ?: it can appear at all ages with a maximum incidence between 30 and 60 years, with 60 years being the average age at the time of diagnosis, that is why we will say that the incidence increases with age, its incidence also increases in patients with chromosomal diseases , such as Down syndrome, Turner syndrome or Klinefelter syndrome, in addition genetic factors are involved in this disease , for example the patient with hashimoto's thyroiditis usually report family history who have had thyroid diseases, we will also say that hashimoto's thyroiditis is often associated with other autoimmune diseases such as Addison's disease , also such as type 1 diabetes mellitus, vitiligo, pernicious anemia and even systemic lupus erythematosus , rheumatoid arthritis and sjögren's syndrome. Now we will look at two main facts about Hashimoto's thyroiditis that have been exam questions. Number one that hashimoto's thyroiditis is the most common cause of eye hypothyroidism in iodine-sufficient areas generally in developed countries and number two is that hashimoto's thyroiditis has an increased risk of thyroid lymphoma . Now what are the signs and symptoms of a hashimoto's thyroiditis? As I told you , hashimoto's thyroiditis is the most frequent cause of hypothyroidism in sufficient iodine areas, but patients often no longer go to the consultation for the symptoms of hypothyroidism but for the goiter, which is the enlargement of the thyroid gland ; Regarding this goiter in hashimoto's thyroiditis, we will see three main characteristics, one that is a painless goiter, it is a painless goiter, 2 is that it is an asymmetric goiter and 3 that it is a diffuse goiter with some exceptions in some patients because it could appear so localized that it could raise suspicion of a neoplasm. Now the big question is why I told you that patients do not go to the consultation due to the symptoms of hypothyroidism and the answer is because in the usual case of hashimoto's thyroiditis, hypothyroidism appears gradually, it means that at the beginning of the disease, the thyroid reserve is usually intact and may show subclinical hypothyroidism, which, as you well know, when referring to subclinical hypothyroidism, does not refer to the absence of symptoms but simply refers to a biochemical state where thyroxine will be normal and TSH will be increased. , TSH or thyroid stimulating hormone and as the disease progresses we will see a hypothyroidism frank to a hypothyroidism with all its corresponding clinic, where we have already talked in a previous video about the signs and symptoms of hypothyroidism, that is why the The main characteristic in the clinic of hashimoto's thyroiditis is the presence of this painless, asymmetric and However, in some patients it may be preceded by a transient hyperthyroidism also called transient thyrotoxicosis and how does this occur? It is going to be produced by the release of thyroid hormones secondary to the rupture of the thyroid follicles and this will obviously cause the thyroid hormones to rise with the consequent decrease in TSH and produces this initial transient or self-limited hyperthyroidism and this transient hyperthyroidism is known such as hashitoxicosis. The diagnosis is made with the study of TSH, as I told you, thyroid stimulating hormone plus free T4 plus thyroid autoantibodies where high titers of thyroid anti-peroxidase are detected and with less frequency of anti-thyroglobulin antibodies and in the case of finding palpable nodules , recommends a thyroid ultrasound and the treatment of this disease comes to be a replacement therapy with levothyroxine. Now if you want to remember key facts about this disease or if you are about to appear for an exam, you should remember the following: in summary we will say that it is a chronic lymphocytic disease that in 1912 was described as lymphomatous goiter, what is the cause of hashimoto's thyroiditis ?: the cause is autoimmune, it is more frequent in women with a maximum incidence between 30 and 60 years, the incidence increases with age and will also increase with chromosomal diseases, it is also associated with other autoimmune diseases, we will also say that it is the most frequent cause of hypothyroidism in sufficient iodine areas, in developed countries, we will also say that it has a greater risk of lymphoma. In the clinic the most representative thing is the painless goiter associated with hypothyroidism and in some cases we can see hashitoxicosis. The diagnosis is made with T4, with TSH plus high titers of thyroid anti-peroxidase and treatment is made with levothyroxine and this is how we culminate with the topic of hashimoto's thyroiditis. LIKE IT, SHARE AND SUBSCRIBE.
