Abstract
BackgroundChronic lymphocytic thyroiditis or Hashimoto’s thyroiditis (HT) is a common form of organ specific autoimmune disease mediated by anti-thyroid autoantibodies. Ultrasound including Doppler is helpful diagnostic tool in the diagnosis of Hashimoto’s thyroiditis. This study aimed to evaluate the ultrasound and Doppler characters of Hashimoto thyroiditis and to analyze the relationship between these ultrasound, Doppler features and thyroid hormones level.ResultsThyroid gland sonographic parenchymal abnormalities (septations, undulation, micronodularity, gland hyper vascularity, hypoechogenicity, sizable nodules as well as enlarged para-tracheal lymph nodes) were significantly higher in Hashimoto cases compared to control group (P value is < 0.001). Undulation of thyroid gland margin was the most sensitive sonographic sign seen in about 72% of studied cases. Thyroid stimulating hormone (TSH) level was significantly high in cases with grade 2 echogenicity compared to cases with grade 0 and grade 1 echogenicity and was significantly high in cases with para-tracheal abnormal enlarged lymph nodes (p < 0.05). TSH & thyroxine (T4) levels were significantly high in cases with high gland vascularity in Doppler study (p < 0.05).ConclusionsUltrasound is a very good diagnostic tool in HT with established signs. It can suggest hypothyroidism (high TSH) in cases of grade 2 parenchymal echogenicity, high vascularity and para-tracheal lymph nodes enlargement. These finding could be helpful in patient management and can contribute in better understanding the disease progression.
Highlights
1 Background Chronic lymphocytic thyroiditis or Hashimoto’s thyroiditis (HT) is a common form of organ specific autoimmune disease mediated by anti-thyroid autoantibodies
Forty-two percent (42%) of cases presented with anterior neck swelling, 13% presented with menstrual irregularity, 12% with easy fatigability & 11% revered by their clinician for goitre noticed in clinical examination
About 8% of cases (8 of 96) are below 20 years, four of them below 15 years. This matches with studies done by Januś et al [17], Zdraveska et al [18], Zois et al [19], all reported that prevalence of chronic type of autoimmune thyroiditis has been assessed as 4–9.6% in adolescents
Summary
Chronic lymphocytic thyroiditis or Hashimoto’s thyroiditis (HT) is a common form of organ specific autoimmune disease mediated by anti-thyroid autoantibodies. Hashimoto’s thyroiditis is one of the common causes of hypothyroidism, which may be subclinical in up to 90% of cases. Mild hypothyroidism may be present in 20% of patients when first seen or can develop over several years [2]. Ultrasound including Doppler is helpful diagnostic tool in the diagnosis of Hashimoto’s thyroiditis [3]. Combination of different sonographic features such as echogenicity, echotexture, vascularity, gland diameters, and glandular margin has high sensitivity and specificity in HT diagnosis [4]
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