Chronic Hashimoto's Thyroiditis Research Articles

Chronic hashimoto's thyroiditis in patients with differentiated thyroid carcinoma- a case-control retrospective study

Chronic hashimoto's thyroiditis in patients with differentiated thyroid carcinoma- a case-control retrospective study

Assessment of cardiovascular risk in male patients with Chronic Hashimoto's Thyroiditis: a systematic review

Introduction: Many studies demonstrate an increased risk of developing coronary heart disease in people with hypothyroidism. Conditions such as hypertension or dyslipidemia associated with patients with Hashimoto's thyroiditis make this risk even greater. Objective: This review aimed to assess the risk of developing cardiovascular disease in patients with Hashimoto's thyroiditis regardless of thyroid hormone changes in males. Methods: Selection of studies in the databases in pairs with another reviewer, using inclusion and exclusion criteria for the selected articles. After this process, the articles underwent data synthesis, data extraction and risk of bias analysis. Results: Some studies demonstrate a higher incidence of cardiovascular diseases in patients with thyroiditis, regardless of the presence or absence of other comorbidities. It is believed that part of this association is related to the deregulation of pro-inflammatory and anti-inflammatory cytokines associated with changes in the lipid profile, leading to endothelial dysfunction and atherosclerosis. But it seems that this association is more important among female patients. Conclusion: Hashimoto's thyroiditis is an uncommon disease in men, with few studies evaluating its association with cardiovascular diseases.

Сучасний підхід до діаґностики та лікування пацієнтів з еутиреоїдними вузловими утвореннями щитоподібної залози

Aim. Improve the effectiveness of diagnosis and the outcome of treatment of patients with nodular nontoxic lesions of the thyroid gland. Material and Methods. During the last five years 2552 patients aged 18-84 were examined and treated, of which 2087 (81.8%) are women and 465 (18.2%) are men. The initial diagnosis was nodular goiter. The final diagnosis was established by using ultrasonography, serum blood tests on the thyrotrophic hormone, thyroxin, thyronine, thyroglubulin, calcitonin, and antibodies' titre to the thyroid peroxidase. The diagnosis was confirmed with fine-needle aspirations and cytological conclusion for 412 patients, and for 326 patients, who were operated on, the diagnosis was verified histologically. Results and Discussion. According to the results of the surveys, including morphological, nodular and multi-nodular colloid goiter was revealed in 1866 (73.1%) patients (198 were operated), thyroid adenoma in 312 (12.2%) patients (51 were operated), thyroid cancer - 43 (1.7%) patients (all operated), chronic Hashimoto's thyroiditis - 326 (12.8%) patients (60 operated), Riedel's thyroiditis and de Quervain's thyroiditis - 5 (0.2%) (two operated). 327 (12.8%) patients had cystic nodules, and 7 (0.3%) patients had multi-nodular retrosternal goiter. For 11 (3.6%) patients with confirmed benign diagnosis of cystic goiter, sclerotherapy was performed. Hormonal suppressive therapy was prescribed for 317 patients, but only 96 (30.3%), according to the results of ultrasonography had a positive temporary effect. Conclusions. For patients with benign thyroid nodules, in the absence of indications for surgery, dynamic observation using ultrasonography and a complex of laboratory tests is recommended. A fine needle aspiration with cytological examination should be performed in the case of the increase of the nodule and suspicion of malignant tumor (TIRADS - 3-4). Surgical treatment is required for patients with malignant thyroid tumors, with large (>3.5 cm) nodules, patients with goiter with the signs of compression of the neck, as well as for patients with subclinical toxic adenoma.

Tiroiditis crónica de Hashimoto: Serie clínica

Chronic Hashimoto Thyroiditis (CHT) is the main cause of hypothyroidism. To report a series of patients with CHT. Retrospective analysis of a series of 27 men aged 38 +/- 14 years and 201 women aged 37 +/- 16 years, evaluated in the private offices of two of the authors. Fifty six percent of patients only had unspecific symptoms at the moment of consultation, 50% had a family history of thyroid diseases and only 21% of women had a previous history of goiter. Eighty one percent of patients had clinical or subclinical hypothyroidism, 62% had both antithyroglobulin and antithyroid peroxidase positive antibodies and 13% had both antibodies negative. Only 1.4% of patients had a normal thyroid ultrasound examination. Patients were treated with levothyroxine at a mean dosage of 75 microg/day and 53% achieved an adequate TSH level. Six often patients operated due to nodules had a papillary carcinoma. CHT should be sought in the general population, especially those with a family history of thyroid disease. Thyroid ultrasound is seldom normal in patients with CHT. Thyroid substitution should be monitored periodically to achieve adequate TSH levels.

ABC of thyroid diseases and their treatment

Thyroid diseases are caused by a disturbance of thyroid hormone secretion, inflammations or tumors of the thyroid or combinations thereof. Most important causes for hyperthyroidism are Graves' disease and toxic nodular goiters (including toxic adenomas). Hypothyroidism is often caused by Hashimoto's chronic thyroiditis and can occur in patients after thyroidectomy. Chronic hashimoto's thyroiditis and subacute de Quervain's thyroiditis are the thyroid inflammations most frequently seen. Graves' disease and Hashimoto's thyroiditis are autoimmune thyroid diseases. Thyroid tumors encompass benign solitary nodules, diffuse and nodular goiters, papillary, follicular, medullary and anaplastic carcinomas.

The Relationship Between Hashimoto’s Thyroiditis, Thyroid Neoplasia, and Primary Hyperparathyroidism

The relationship between Hashimoto's thyroiditis and follicular cell carcinoma of the thyroid remains controversial. Hashimoto's thyroiditis is regarded by some as a premalignant lesion for which thyroidectomy is definitely indicated. In contrast, other investigators have found no increased evidence of thyroid carcinoma in patients with this disease. As a result, the management of thyroid nodules in patients with Hashimoto's thyroiditis remains highly individualized. A program for the management of patients with chronic Hashimoto's thyroiditis with co-existing neoplasia or primary hyperparathyroidism is outlined.

Intrathyroidal and circulating lymphocyte subsets in different stages of autoimmune postpartum thyroiditis.

Postpartum thyroiditis (PPT) is a reversible form of lymphocytic thyroiditis which has been attributed to an aggravation of preexisting subclinical autoimmune thyroiditis. In this study no differences in circulating lymphocyte subsets were found between 9 thyrotoxic and 18 hypothyroid PPT patients and normal subjects. We obtained sufficient numbers of thyroid-infiltrating lymphocytes for surface marker characterization in 3 women in the thyrotoxic phase and in 10 women in the hypothyroid phase of PPT. Cells were identified by conventional T and B cell markers as well as by monoclonal antibodies (OKT) directed against different T cell subsets in a microscale immunofluorescence assay. In the hypothyroid patients a relative accumulation of B cells (31% vs. 17%; P less than 0.01 by the Wilcoxon signed rank test) was found within the thyroid when compared to peripheral blood. A relative decrease in intrathyroidal supressor-cytotoxic (OKT 8+) T cells (19% vs. 28%; P less than 0.01) resulted in an increased intrathyroidal helper to suppressor-cytotoxic (OKT 4+/OKT 8+) T cell ratio (3.0 vs. 2.0; P less than 0.01). Intrathyroidal lymphocyte subsets in the thyrotoxic patients were comparable to those in the hypothyroid patients. These findings, which are similar to those we previously obtained in patients with chronic Hashimoto's thyroiditis, may indicate that local synthesis of thyroid-directed autoantibodies is of primary importance in all stages of autoimmune thyroiditis.