Abstract
OBJECTIVE: To evaluate the morphology of non-toxic goiter, the role of auto-immunity and lipid abnormalities in overt and sub-clinical hypothyroid goiter patients. METHODS: A descriptive observational study was undertaken amongst goiter patients without thyrotoxic features comprising 50 randomly selected cases within the range of 12-65years. Goiter patients with thyrotoxic features, acute illness and other visceral diseases were excluded. The patients were evaluated with thyroid function tests, USG-thyroid, FNAC-thyroid, anti-TPO and lipid profile after thorough clinical examination. RESULTS: In my study, most patients were female (with male: female ratio 1:5.25) and were middle aged (between age group 30-49years). Among all patients 60 %( i.e. 30) patients had Hashimoto's thyroiditis, 24% (i.e. 12) patients had diffuse colloid goiter and 16% (i.e. 8) patients had nodular goiter. 52% (i.e. 26) of all patients and 76.6% (i.e. 23) of Hashimoto's goiter patients were anti-TPO positive. Majority of colloid goiter (i.e. 66.7%) and nodular goiter (50%) patients were euthyroid but majority of Hashimoto's goiter patients were hypothyroid (65.38% overt and 33% sub-clinical). Majority of anti-TPO positive patients were hypothyroid (65.38% overt and 30.62% sub-clinical) and majority of anti-TPO negative patients (66.67%) were euthyroid. Within reference range of TSH, there was a linear increase in total serum cholesterol, LDL- cholesterol, triglyceride and decrease in HDL-cholesterol with increase in TSH. This lipid profile changes are mainly seen in Hashimoto goiter patients. CONCLUSION: this study emphasizes the role of auto-immunity in non-toxic goiter patients especially Hashimoto's thyroiditis patients and lipid profile changes in those patients.
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