Diagnosis and treatment of Hashimoto's autoimmune thyroiditis

Content

  • The causes of the disease
  • Classification of diseases
  • Laboratory diagnosis
  • Principles of treatment of autoimmune thyroiditis


  • Autoimmune Hashimoto's thyroiditis is most common between the ages of 40 - 50 years and is one of the most common causes of primary hypothyroidism.



    The causes of the disease

    Diagnosis and treatment of Hashimoto's autoimmune thyroiditisIt is believed that the main cause of the diseaseThey are congenital disorders of the immune system. Often both conditions combined with not endocrine autoimmune diseases (vitiligo, myasthenia gravis, rheumatoid arthritis, ulcerative colitis, etc.).

    As a result of autoimmune destruction of the thyroidglands produce antibodies to different components of the thyroid (thyroglobulin, microsomal fraction) to form an antigen-antibody complex, the development of changes in the thyroid gland.

    Risk factors include autoimmune thyroiditis:

    • Moved Graves' disease history
    • Moved surgery on the thyroid gland
    • presence of autoimmune diseases
    • the presence of relatives, patients with autoimmune thyroiditis



    Classification of diseases

    Autoimmune Hashimoto's thyroiditis may have the following clinical options:

    • Hypertrophic (hyperplastic) shape - formed goiter
    • atrophic form
    • Alopecia form - the defeat of one lobe of the thyroid gland



    Laboratory diagnosis

    Autoimmune Hashimoto's thyroiditis developsgradually, in the initial stages it is accompanied only by general weakness and fatigue. The general analysis of blood marked increase in white blood cells, ESR, on average up to 30 mm / h, sometimes 50-60 mm / h.

    The results of hormone tests may be different - from euthyrosis to overt hypothyroidism, accompanied by anemia and elevated levels of cholesterol in the blood.

    Normally the titer and antitireoglobulinovyhantimikrosomalnyh antibodies does not exceed 1: 100. Titers above 1: 400 indicate Hashimoto's thyroiditis (detected in 95% of cases). Antithyroid antibodies to thyroglobulin are detectable and in certain other autoimmune diseases (systemic lupus erythematosus, rheumatoid arthritis, autoimmune hemolytic anemia).

    On US - heterogeneity of the thyroid structuregland, sometimes calcifications in breast tissue. Often in patients with autoimmune thyroiditis Hashimoto's thyroid nodules occur, which seldom ozlokachestvlyayutsya.



    Principles of treatment of autoimmune thyroiditis

    In autoimmune thyroiditis, euthyroid - treatmentnot shown. With an increase in thyroid volume may be possible to assign the L-thyroxine for obstacles immune processes and reduce goiter size.

    In autoimmune thyroiditis and hypothyroidism - required replacement therapy with L-thyroxine.

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