Correlation of Biochemical Parameters with Cytomorphological grading in Hashimoto’s Thyroiditis

Amrita Dhakal Sharma,Navya B N Navya B N,Sathyavathi R Alva

doi:10.21276/apalm.2580

Amrita Dhakal Sharma, Navya B N Navya B N + Show 1 more

Open Access

https://doi.org/10.21276/apalm.2580

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Abstract

Background: Hashimoto’s thyroiditis (HT) is one of the most common cause of hypothyroidism in iodine sufficient areas. Diagnosis of HT is based on clinical, cytomorphological and biochemical parameters. Fine Needle Aspiration Cytology (FNAC) of thyroid provides a safe and accurate method for diagnosis of HT. Cytological grading of HT helps in assessing the severity of the disease and can predict the thyroid functional status. Methods: Retrospectively, 50 diagnosed cases of HT on FNAC were studied over a period of 6 months in a tertiary care hospital. Clinical, biochemical parameters such as T3, T4 and TSH values were collected. Cytological grading of FNAC smears was done based on Bhatia et al cytological grading system into three grades. These grades were compared with the clinical and biochemical parameters of HT. Result: Of 50 patients, 47 were females. Maximum number of cases were seen between 36 -45 years. Most of the patients presented with goiter. 31 out of 50 (62%) cases were grade II thyroiditis, of them most cases were hypothyroid. 17 out of 50 cases (34%) were grade I thyroiditis, of which most cases were euthyroid biochemically. Conclusion: Higher the grades of HT in cytology the more abnormal are the biochemical parameters. A combined approach of cytological grading along with clinical and biochemical parameters can detect subclinical hypothyroid state which provides a guide to therapy.

Highlights

In 1912 Hakaru Hashimoto first described Hashimoto’s thyroiditis(HT)
A combined approach of cytological grading along with clinical and biochemical parameters can detect subclinical hypothyroid state which provides a guide to therapy
Diagnosis of HT is based on clinical features, thyroid function test, anti-thyroid peroxidase antibody test and on fine needle aspiration cytology(FNAC).[4]

Summary

Introduction

In 1912 Hakaru Hashimoto first described Hashimoto’s thyroiditis(HT). HT is one of the most common causes of hypothyroidism and is known as chronic lymphocytic thyroiditis or autoimmune thyroiditis. [1] This disorder is prevalent between 45- 65 years of age, has a prevalence rate of 1-4% and incidence of 30-60/1 lakh population per year with a female predominance of 10:1 to 20:1. [2] HT has a strong genetic association with concordance of disease in as many as 40% of monozygotic twins. Diagnosis of HT is based on clinical features, thyroid function test, anti-thyroid peroxidase antibody test and on fine needle aspiration cytology(FNAC).[4] FNAC is a simple, cost-effective and safe procedure. It is specific and sensitive in diagnosing and grading HT which helps in assessing the severity of the disease and can predict the thyroid functional status.[5] FNAC remains the gold standard test despite several tests for diagnosis of HT.[6] This study is aimed at grading the thyroiditis on FNAC and correlating the cytological grades with the clinical and biochemical findings. Cytological grading of HT helps in assessing the severity of the disease and can predict the thyroid functional status

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