Unique Features of Hashimoto’s Thyroiditis in Coastal South India – a study from a tertiary care hospital

Background: Hashimoto’s thyroiditis is an autoimmune disorder of thyroid gland. It is one of thecommon causes of hypothyroidism and is common in females. Generally, Hashimoto’s thyroiditisclinically presents as diffuse enlargement of the thyroid and nodular lesions are uncommon. But fewrecent studies from South India have shown that Hashimoto’s frequently presents as nodularenlargement of the thyroid. Such lesions can be easily confused with nodular goitre. Objectivesand Aim: Aim of the study is to study the clinicopathological features of Hashimoto’s thyroiditis andto estimate the frequency of nodular lesions in Hashimoto’s thyroiditis in a tertiary care healthcentre in coastal South India. Materials and Methods: The present study was done retrospectivelyon patients diagnosed as Hashimoto’s thyroiditis by fine-needle aspiration cytology during the periodJune 2017 to June 2020. Their clinical details, clinical examination findings including diffuse/nodularnature of the swelling, thyroid hormone status and ultrasound findings were studied. Results: In thepresent study, 102 cases of Hashimoto’s thyroiditis were included, which includes 91 females and 11males. Patients age ranged from 15 to 63 years with a peak in the fourth decade. Fifty-five cases(53.9%) were hypothyroid and 43 (42.2%) were euthyroid. Fifty cases (49%) presented as nodularlesion out of which 47 cases had multiple nodules. Conclusion: Nodular enlargement of the thyroidis a common finding in Hashimoto’s thyroiditis patients. Such cases should not be mistaken fornodular goitre as there is a risk of malignancy in Hashimoto’s thyroiditis.

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A comparative study of postoperative hypocalcaemia following total thyroidectomy in patients with Hashimoto’s thyroiditis and multinodular goitre in a rural tertiary care hospital

International Surgery Journal ◽

10.18203/2349-2902.isj20203253 ◽

2020 ◽

Vol 7 (8) ◽

pp. 2668

Author(s):

Amrutha P. ◽

Arun P. Joseph ◽

Anna Mathew ◽

John Michael Raj

Keyword(s):

Total Thyroidectomy ◽

Hashimoto’S Thyroiditis ◽

Tertiary Care ◽

Significant Risk ◽

Hashimoto's Thyroiditis ◽

Histopathological Diagnosis ◽

Care Hospital ◽

Multinodular Goitre ◽

Antibody Testing ◽

Tertiary Care Centre

Background: Recurrent laryngeal nerve injury, hypothyroidism and hypocalcaemia have long been recognized as the three main sequalae of thyroidectomy. Persistent hypocalcaemia may cause intracranial lesions and cardiac arrhythmias. As the definitive diagnosis of Hashimoto’s thyroiditis was not always possible with clinical and cytological parameters when antibody testing was not done, surgery was planned with the diagnosis of multinodular goitre. This study was conducted to find out the incidence of post-operative hypocalcaemia following total thyroidectomy by skilled surgeons in patients with multinodular goitre and Hashimoto’s thyroiditis.Methods: This was a cross-sectional study to compare the incidence of hypocalcaemia in patients with biopsy-proven Hashimoto’s thyroiditis and multinodular goitre. After obtaining approval from the institutional review board and ethics committee, data was collected serially, from the surgical records of 123 patients who underwent total thyroidectomy in this tertiary care centre, during the past two years.Results: The incidence of post-operative hypocalcaemia (71.1%) in patients undergoing total thyroidectomy with Hashimoto’s thyroiditis was significantly higher than in patients with multinodular goitre (56.4%). Of the 45 patients who had a biopsy report of Hashimoto’s thyroiditis, 8 (17.8 %) developed permanent hypocalcaemia while only 8 (10.3%) of the 78 patients with histopathological diagnosis of multinodular goitre developed persistent hypocalcaemia needing supplementation following total thyroidectomy in this rural tertiary care hospital.Conclusions: The significant risk of post-operative hypocalcaemia should be kept in mind before opting for total thyroidectomy for benign lesions of the thyroid and pre-operative antibody studies must be done to diagnose Hashimoto’s thyroiditis.

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Correlation of fine needle aspiration cytology with histopathology for thyroid swellings in a tertiary care hospital in South India

Сибирский научный медицинский журнал ◽

10.15372/ssmj20200509 ◽

2020 ◽

Keyword(s):

Fine Needle Aspiration ◽

Fine Needle Aspiration Cytology ◽

South India ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Needle Aspiration ◽

Care Hospital ◽

Aspiration Cytology ◽

Fine Needle ◽

Needle Aspiration Cytology

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Antithyroid Peroxidase Antibodies in Multinodular Hashimoto’s Thyroiditis Indicate a Variant Etiology

Journal of Thyroid Research ◽

10.1155/2019/4892329 ◽

2019 ◽

Vol 2019 ◽

pp. 1-5 ◽

Cited By ~ 1

Author(s):

Pabithadevi B. Mehanathan ◽

R. Raskin Erusan ◽

K. Shantaraman ◽

S. M. Kannan

Keyword(s):

Clinical Features ◽

Hashimoto’S Thyroiditis ◽

Tamil Nadu ◽

Tertiary Care ◽

Hashimoto's Thyroiditis ◽

P Value ◽

Care Hospital ◽

Thyroid Disorder ◽

Autoimmune Thyroid ◽

South Indian

Introduction. Hashimoto’s thyroiditis (HT) is a common autoimmune thyroid disorder, which predominantly presents as a diffuse goiter, with few studies which report HT presenting as multinodular goiter, with variable frequencies ranging from 59% to 78.6% especially from south Indian populations. This variant clinical presentation may have diagnostic challenges which require further analysis. Anti-TPO antibodies are more common (90-95%) in Hashimoto’s thyroiditis than anti-TG antibodies in Hashimoto’s thyroiditis. This study analyzes the clinical features and the correlation of anti-TPO levels with diffuse and multinodular forms of HT. Material and Methods. This study was conducted in the Department of General Surgery in a tertiary care hospital in south Tamil Nadu. Patients presenting with clinical features of a thyroid disorder were interviewed and given a detailed clinical, radiological examination and guided FNAC. Those patients diagnosed by FNAC as HT were registered and a sample of 3cc of blood was drawn for T3, T4, TSH, and anti-TPO analysis. All the data were tabulated. Results and Discussion. Of the 212 patients who presented with goiters, 96 were diagnosed by FNAC as having a cytological picture suggestive of Hashimoto’s thyroiditis. Of these 96 patients with HT, 46 (47.9%) were multinodular (HT-MNG), 14 (14.58%) were solitary nodules (HT-SNT), and the remaining 36 (37.5%) were diffuse goiters (HT-D). Of the 46 patients who are HT-MNG, 36.9% had elevated anti-TPO-Ab (more than 35.0U/l) and 63.1% had normal/lower values (less than 35.0U/l). But of 36 patients with HT-D, 77.7% had elevated anti-TPO-Ab levels (>35U/l). Chi square statistics was 15.8346 and the p value is 0.0005 (<.05). Eight cases of HT-D and 3 cases of HT-MNG had hyperthyroidism and 3 cases of HT-D had hypothyroidism and all other cases were in euthyroid state. Conclusion. Patients presenting as multinodular Hashimoto’s thyroiditis have low prevalence of elevated anti-TPO-Ab than diffuse HT which suggests that multinodular form of Hashimoto’s thyroiditis is a unique clinical entity with etiopathogenesis that is at variance with the diffuse form.

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