'Hashimoto's thyroiditis' or 'chronic lymphocytic thyroiditis' is an
autoimmune disease where the body's own
antibodies attack the
cells of the
thyroid.
This disorder is believed to be the most common cause of primary hypothyroidism in
North America. It occurs far more often in women than in men (10:1 to 20:1), and is most prevalent between 45 and 65 years of age.
In European countries an
atrophic form of
autoimmune thyroiditis (
Ord's thyroiditis) is more common than Hashimoto's thyroiditis.
Causes
A family history of thyroid disorders is common, with the ''
HLA-DR5'' gene most strongly implicated conferring a
relative risk of 3 in the UK.
The genes implicated vary in different ethnic groups and the incidence is increased in patients with chromosomal disorders, including
Turner,
Down's, and
Klinefelter's syndromes.
The underlying specifics of the immune system destruction of thyroid cells is not clearly understood.
Various autoantibodies may be present against thyroid peroxidase, thyroglobulin and TSH receptors, although a small percentage of patients may have none of these antibodies present. A percentage of the population may also have these antibodies without developing Hashimoto's thyroiditis.
Presentation
In many cases, Hashimoto's thyroiditis usually results in
hypothyroidism, although in its acute phase, it can cause a transient
thyrotoxic state.
Physiologically,
antibodies against
thyroid peroxidase and/or
thyroglobulin cause gradual destruction of
follicles in the
thyroid gland. Accordingly, the disease can be detected clinically by looking for these antibodies in the blood. It is also characterised by invasion of the thyroid tissue by
leukocytes, mainly
T-lymphocytes. It is associated with
non-Hodgkin lymphoma.
Symptoms of Hashimoto's thyroiditis include symptoms of
hypothyroidism and a
goitre.
Treatment
Treatment is with daily
thyroxine, with the sodium salt of thyroxine liothyronine given when the need to raise levels of circulating thyroxine is urgent.
Eponym
Also known as 'Hashimoto's disease', Hashimoto's thyroiditis is named after the
Japanese physician
Hashimoto Hakaru (1881−1934) of the medical school at
Kyushu University,
[1] who first described the symptoms in 1912 in a German publication
[2].
Noted sufferers
★
Anna Nicole Smith [ The Smoking Gun]
References
1.
2. H. Hashimoto: ''Zur Kenntnis der lymphomatösen Veränderung der Schilddrüse (Struma lymphomatosa).'' Archiv für klinische Chirurgie, Berlin, 1912, 97: 219−248.
External links
★
Hashimoto's disease at the
Mayo Clinic