hashimoto's thyroiditis

Question 1

What is hashimoto thyroiditis?

Answer 1

autoimmune inflammation of the thyroid tissue

Question 2

What other conditions is it associated with?

Answer 2

1. Type 1 diabetes
2. Grave’s disease
3. HLA DR3/4 associated

Question 3

What are the main clinical features?

Answer 3

1. Goiter - non tender and painless

2. Hyperthyroidism /hypothyroidism symptoms

Question 4

Describe the disease progression of hashimoto’s thyroiditis?

Answer 4

1. early stage - hyperthyroidism
2. subclinical hypothyroidism
3. overt hypothyroidism

Question 5

What is ‘subclinical hypothyroidism’?

Answer 5

1. High TSH

2. T3 and T4 still normol

Question 6

TFTS - overt hypothyroidism

Answer 6

1. high TSH
2. low T4
3. low T3

Question 7

Antibodies - Hashimoto thyroiditis

Answer 7

1. anti - TPO +

2. anti - Tg +

Question 8

What further imaging/investigations need to be done?

Answer 8

1. Ultrasound
2. Fine needle aspiration
3. Radioactive iodine uptake rest

Question 9

Tx of hashimoto thyroiditis

Answer 9

Levothyroxine T4 replacement lifelong