A Review on Hashimoto’s Thyroiditis

Abstract

Hashimoto's thyroiditis (HT) is an autoimmune thyroid disorder first described by Japanese physician Haraku Hashimoto in 1912 characterized by lymphocytic infiltration of the thyroid parenchyma and is influenced by immune system instability. The onset of autoimmunity may be influenced by innate and acquired immune responses. Thyroid autoantibodies (TAbs) are the primary biochemical feature. Epidemiological studies show AITD (autoimmune thyroid disease) risk is higher in women and is age-related. Risk factors include high iodine consumption, selenium insufficiency, infectious disorders, and specific medications. Genetic predisposition and environmental factors also contribute to HT. Pregnancy and sex steroids play a role in the development of autoimmune thyroiditis, with older women being more susceptible. The immune system is modified during pregnancy, with progesterone playing a significant role. About 20% of postpartum thyroiditis patients eventually develop HT. The symptoms include dysphonia, dyspnea, and dysphagia, with primary hypothyroidism causing greater systemic symptoms. Diagnosis involves circulating thyroid-specific antibodies, ultrasound examination, increased thyroid stimulating hormone, and normal serum thyroid hormone levels. Ultrasonography is crucial for diagnosing Hashimoto's thyroiditis, distinguishing it from other thyroid disorders like Graves' disease (GD). The treatment comprises levothyroxine, which effectively lowers thyroid volume, as well as vitamin D deficiency and replacement. Autoimmune thyroiditis (AIT) surgery has traditionally been reserved for people who have discomfort or compressive symptoms from goitre or co-existing malignant thyroid nodules. Thyroidectomy has lately been advocated as a treatment option for decreasing TPOAbs, as the presence of such antibodies is linked to a worse quality of life even in euthyroid patients.
 Keywords: Hashimoto’s thyroiditis (HT), Autoimmune thyroid disease (AITD), Autoimmune thyroiditis (AIT) Vitamin D , Levothyroxine