Hashimoto's Thyroiditis

Question 1

what is the definition of hashimotos thyroiditis

Answer 1

form of autoimmune hypothyroidism

Question 2

what is the epidemiology of hashimotos thyroiditis?

Answer 2

more common in females, middle age and women ages 60-70yrs

Question 3

what is the aetiology and risk factors of hashimotos thyroiditis?

Answer 3

Genetic predisposition, other family members with hashimotos or other autoimmune disease

Question 4

what is the brief pathophysiology of hashimotos thyroiditis?

Answer 4

Produces atrophic changes with regeneration that results in GOITRE FORMATION due to lymphocytic and plasma cell infiltration

Question 5

what are the key presentations of hashimotos thyroiditis?

Answer 5

• Gland is usually firm and rubbery but may range from soft to hard
  • Thyroid peroxidase is an enzyme essential for the production and storage of thyroid hormone
  • Thyroid peroxidase antibodies (TPO-Ab) are present in HIGH TITRES
  • Patients may be hypothyroid or euthyroid (normal thyroid function)

Question 6

what are the signs of hashimotos thyroiditis?

Answer 6

High thyroid peroxidase antibodies, other signs of hypothyroidism

Question 7

what are the symptoms of hashimotos thyroiditis?

Answer 7

Fatigue and sluggishness
Increased sensitivity to cold
Constipation
Pale, dry skin
A puffy face
Brittle nails
Hair loss
Enlargement of the tongue
Unexplained weight gain
Muscle aches, tenderness and stiffness
Joint pain and stiffness
Muscle weakness
Excessive or prolonged menstrual bleeding
Depression
Memory lapses

Question 8

what are the first line investigations for hashimotos thyroiditis?

Answer 8

anti-thyroid antibody tests

Question 9

what are the gold standard investigations for hashimotos thyroiditis?

Answer 9

Other thyroid blood tests, TSH, thyroxine and thyroid hormones, test for hypothyroidism

Question 10

what are the differential diagnoses for hashimotos thyroiditis?

Answer 10

Autoimmune gastritis (pernicious anemia) Chronic active hepatitis. Idiopathic hypoparathyroidism. Polymyalgia rheumatica and giant cell arteritis

Question 11

how is hashimotos thyroiditis managed?

Answer 11

LEVOTHYROXINE (T4) THERAPY may shrink the goitre, even when the patient is not hypothyroid. May also use triiodothyronine (T3)

Question 12

how is hashimotos thyroiditis monitored?

Answer 12

blood tests, monitor drugs

Question 13

what are the complications of hashimotos thyroiditis?

Answer 13

Goiter. Constant stimulation of your thyroid to release more hormones may cause the gland to become enlarged, a condition known as a goiter.
Heart problems
Mental health issues
Myxedema
Birth defects.

Question 14

what is the prognosis of hashimotos thyroiditis?

Answer 14

Excellent with proper treatment, restoration of thyroid hormone levels with medical treatment will reverse the signs and symptoms of hypothyroidism. Without treatment, hypothyroidism can worsen over years, potentially leading to organ damage and severe illness