Autoimmune Thyroid Diseases

Abstract

Autoimmune thyroid disease is characterized by the presence of autoantibodies against thyroid peroxidase (TPO), thyroglobulin (Tg), and the thyroid simulating hormone recep­ tor (TSHR). The thyroid gland is a site of autoantibody secretion in autoimmune thyroid disease by the B cells infiltrated into the thyroid. Hashimoto’s thyroiditis, a chronic autoim ­ mune thyroid disease, characterized by the occurrence of high levels of serum thyroid an­ tibodies for TPO and Tg and goiter, is the most common type of thyroiditis. A firm, diffuse, painless goiter is the most common initial finding in Hashimoto’s thyroiditis. Some patients have atrophic thyroid glands rather than goiter, which may represent the final stage of thyroid failure in Hashimoto’s thyroiditis. Levothyroxine is the treatment of choice for Ha­ shimoto’s thyroiditis presenting overt hypothyroidism. Patients with Hashimoto’s thyroid­ itis and a thyroid nodule should undergo fine ­needle aspiration biopsy to rule out lym­ phoma and thyroid carcinoma. Graves’ disease is the most common cause of spontaneous hyperthyroidism in patients younger than 40 years of age. Patients with Graves’ disease re­ veal heterogeneous lymphocytic infiltration without follicular destruction and also show various clinical presentations.