scholarly journals A correlative study of antithyroid antibodies level, thyroid functional status and histological evidence of thyroiditis in patients subjected to thyroidectomy

2017 ◽  
Vol 4 (9) ◽  
pp. 2991
Author(s):  
Ravi Desai P. ◽  
Chetan Anand ◽  
Ganesh Babu C. P. ◽  
Ananthakrishnan N.
Keyword(s):  
Functional Status ◽  
Hashimoto’S Thyroiditis ◽  
Primary Diagnosis ◽  
Hashimoto's Thyroiditis ◽  
Antithyroid Drugs ◽  
Thyroid Function Tests ◽  
Secondary Diagnosis ◽  
Antithyroid Antibody ◽  
Histological Evidence ◽  
Antibody Levels

Background: There is inadequate data on relationship between histologic thyroiditis, thyroid functional status and antithyroid antibody levels. Aim of the study was to correlate prevalence of antithyroid antibody levels with thyroid functional status and histological evidence of thyroiditis in thyroidectomy specimen.Methods: Thirty-two patients undergoing thyroidectomy were evaluated clinically and with thyroid function tests, preoperative TPOAb and TGOAb, ultrasound neck and FNAC. Histopathological examination to detect histological thyroiditis done. Patients with previous thyroid surgery or on thyroxine, antithyroid drugs, steroids, immune-suppressive drugs were excluded. Results: Overall twenty-five out of thirty-two patients had elevation of one or other thyroid antibody levels (TPOAb- 22/32, TGOAb- 20/32). More than half of the patients with elevated antibodies were euthyroid biochemically, less than quarter each being hypothyroid and hyperthyroid. The incidence of hypothyroid increased in those with elevation of both antibody levels. FNAC reported four as Hashimoto's thyroiditis. Histology on the other hand showed a primary diagnosis of Hashimoto's thyroiditis in three, in one each as the secondary diagnosis with papillary carcinoma being the primary diagnosis in one and follicular adenoma in another. Histologic lymphocytic thyroiditis was seen in three cases and found to be always associated with a primary diagnosis such as colloid goitre. Thus, overall five patients had an additional primary diagnosis with thyroiditis being a secondary diagnosis. When histological thyroiditis was correlated with antibodies, it was seen that only seven out of eight with histological thyroiditis had elevated antibody levels. High titters in patients with histological thyroiditis were associated with euthyroid status in two patients and hyperthyroid status in the remaining three.Conclusions: The study found no correlation between clinical and biochemical functional status with clinical examination under diagnosing both hypothyroidism and hyperthyroidism. No definite correlation was noted with mild increases in antithyroid antibody levels and histological thyroiditis, very high values and raises in both TPOAb and TGOAb may suggest histological thyroiditis.

scholarly journals Thyroid Hemiagenesis Associated with Hashimoto’s Thyroiditis

2013 ◽  
Vol 2013 ◽  
pp. 1-3 ◽  
Author(s):  
D. Nsame ◽  
A. Chadli ◽  
L. Hallab ◽  
S. El Aziz ◽  
H. El Ghomari ◽  
...  
Keyword(s):  
Hashimoto’S Thyroiditis ◽  
Left Lobe ◽  
Hashimoto's Thyroiditis ◽  
Antithyroid Drugs ◽  
Antithyroid Antibody ◽  
Thyroid Lobe ◽  
Hormone Substitution ◽  
Current Case ◽  
Thyroid Hemiagenesis ◽  
Right Lobe

Thyroid hemiagenesis is a rare congenital anomaly resulting from failure of one thyroid lobe development. We report a 23-year-old female presented with Hashimoto’s thyroiditis in left lobe, associated with hemiagenesis of right lobe and isthmus which was previously diagnosed as Graves’ hyperthyroidism, but developed further into Hashimoto’s thyroiditis after being treated with antithyroid drugs. The symptoms of hyperthyroidism in the current case led to the diagnostic confirmation by scintiscanning of an absent lobe. The antithyroid pharmacotherapy by thiamazole was used. However, due to symptoms of hypothyroidism, it was discontinued two months later, so thyroid hormone substitution was reintroduced. Antithyroid antibody studies and ultrasonography documented the presence of Hashimoto’s thyroiditis.

scholarly journals Hyperthyroid Phase of Hashimoto's Thyroiditis

2019 ◽  
Vol 26 (1) ◽  
pp. 123
Author(s):  
Siti Nurul Hapsari ◽  
Sidarti Soehita
Keyword(s):  
Hashimoto’S Thyroiditis ◽  
Benign Lesion ◽  
Peripheral Blood Smear ◽  
Liver Function Tests ◽  
Hashimoto Thyroiditis ◽  
Ca 125 ◽  
Hashimoto's Thyroiditis ◽  
Thyroid Function Tests ◽  
Chronic Autoimmune Thyroiditis ◽  
Function Tests

Hashimoto thyroiditis (chronic autoimmune thyroiditis) is the most common cause of hypothyroidism in iodine-sufficient areas of the world. This condition, however, can sometimes show hyperthyroidism. A 39-year-old femalewas admitted to hospital due to shortness of breath and tremor four hours before hospitalization. There were nausea, chestpain, cold chills, and palpitation. She was diagnosed with Hashimoto's thyroiditis and routinely received tyrosol,propranolol, and dexamethasone. Physical examination showed cervical mass, afebrile, blood pressure of 130/70 mmHg,pulse rate of 110 beats/minute and respiratory rate of 20 breaths/minute. Laboratory examinations showed WBC 7.53 x 109/L, Hb 11.0 g/dL and platelet count of 168 x 109/L. Chest X-Ray: negative for infiltrates. Several laboratory testswere performed, abnormal results were as follows: FT4 level of 2.96 ng/dL (increased), TSH level of 0.003 µIU/mL(decreased), anti-TPO (antithyroid microsomal antibody) level of 306 IU/ml (increased), and IgE level of 213.6 IU/mL(increased). Peripheral blood smear, coagulation test, serum electrolytes, liver function tests, renal function tests, urinalysis,CEA and Ca 125 were within normal limits. Thyroid ultrasound was performed and showed a benign lesion. Fine needleaspiration biopsy showed lymphocytic Hashimoto's thyroiditis. Echocardiography showed hyperthyroid heart disease. Dueto an increase of anti-TPO and FT4 levels, a decrease of TSH levels and lymphocytic thyroiditis from FNAB, this patient wasdiagnosed with a hyperthyroid phase of Hashimoto's thyroiditis. Thyroid function tests and thyroid antibody tests must bemonitored to distinguish between the hyperthyroid and hypothyroid phase of Hashimoto thyroiditis.

scholarly journals Stress-induced hashitoxicosis: case report and relative HLA serotype and genotype

2019 ◽  
Vol 65 (6) ◽  
pp. 830-833 ◽  
Author(s):  
Roberto Vita ◽  
Valeria Cernaro ◽  
Salvatore Benvenga
Keyword(s):  
Hashimoto’S Thyroiditis ◽  
Stressful Life Events ◽  
Normal Values ◽  
White Cell Count ◽  
Hashimoto's Thyroiditis ◽  
Stressful Event ◽  
Graves Disease ◽  
Thyroid Function Tests ◽  
Receptor Antibodies ◽  
Tsh Receptor Antibodies

SUMMARY OBJECTIVE Even though stress has been long known as a provocative factor for Graves’ disease, its relationship with Hashimoto's thyroiditis is more controversial. Studies on this topic are scanty. This paper aims to report a case of stress-induced Hashitoxicosis. RESULTS Here we report a case of Hashitoxicosis induced by a psychological stressful event in a 28-year-old woman with Hashimoto's thyroiditis. She had remained stably euthyroid for 12 years. She was first observed in April 2016, while euthyroid. She came back after 11 months because of fatigue and palpitations, in the absence of neck pain. Thyroid function tests revealed moderate thyrotoxicosis (undetectable TSH; FT4 36.94 pmol/L, normal values 9.0-24.46; FT3 13.50 pmol/L, normal values 3.07-6.14) with negative TSH-receptor antibodies. In the previous three months, she had experienced a psychological stressful event. Inflammatory markers were negative, and the white cell count was normal. Thyroid ultrasound revealed a modest increase in vascularization. Transient subclinical hypothyroidism ensued after seven weeks and spontaneously recovered. On the last visit, the patient was still on euthyroidism. (TSH 1.01 mU/L; FT4 9.22 pmol/L; FT3 3.98 pmol/L). We also performed HLA serotyping and genotyping. CONCLUSION This case demonstrates that, similarly to Graves’ disease, Hashitoxicosis can also be triggered by stressful life events.

scholarly journals Cytomorphological Aspects of Hashimoto's Thyroiditis: Our Experience at a Tertiary Center

2014 ◽  
Vol 7 ◽  
pp. CPath.S13580 ◽  
Author(s):  
Monika Rathi ◽  
Faiyaz Ahmad ◽  
Satish Kumar Budania ◽  
Seema Awasthi ◽  
Ashutosh Kumar ◽  
...  
Keyword(s):  
Fine Needle Aspiration ◽  
Hashimoto’S Thyroiditis ◽  
Fine Needle Aspiration Cytology ◽  
Needle Aspiration ◽  
Hashimoto's Thyroiditis ◽  
Thyroid Function Tests ◽  
Aspiration Cytology ◽  
Fine Needle ◽  
Tertiary Center ◽  
Needle Aspiration Cytology

Introduction Hashimoto's thyroiditis is the most common form of acquired hypothyroidism. Fine needle aspiration cytology is one important tool in diagnosing Hashimoto's thyroditis, along with clinical, biochemical, immunological and ultrasonographical modalities. The present study examines cytological aspects of Hashimoto's thyroiditis along with their correlation with clinical, biochemical and immunological findings, whenever available. Materials and Methods This is a retrospective study of 50 cases of Hashimoto's thyroiditis. Cytological findings were reviewed and correlated with clinical, biochemical and immunological findings whenever available. Results The majority of the patients were middle-aged females, with a female to male ratio of 6.14:1. Most patients presented with diffuse thyromegaly (68%) and/or hypothyroidism (56.09%). The antibody profile was available in 22% of patients. Of these, anti-thyroid peroxidase antibodies were raised in 81.81% of patients and anti-thyroglobulin antibodies were raised in 63.63% of patients. In the present study, high lymphoid to epithelial cell ratio was seen in 78% of cases, and 74% of cases showed Hurthle cell change. Follicular atypia was seen in 36% of cases. Lymphoid follicle formation was seen in seen in 54% of cases. Follicular cell infiltration by lymphocytes, eosinophils and neutrophils was seen in 72%, 48% and 26% of cases, respectively. Plasma cells were seen in 18% of cases. Conclusion Thyroid function tests and immunological tests cannot diagnose all cases of Hashimoto's thyroiditis. Fine needle aspiration cytology continues to be a diagnostic tool of significance in diagnosing Hashimoto's thyroiditis. The presence of inflammatory cells, particularly lymphocytes and eosinophils, was detected in a significant proportion of cases.

Avoidance of iodine deficiency/excess during pregnancy in Hashimoto’s thyroiditis

2021 ◽  
Author(s):  
Lutz van Heek ◽  
Christiane Staudacher ◽  
Michael Faust ◽  
Costanza Chiapponi ◽  
Jasmin Mettler ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Hashimoto’S Thyroiditis ◽  
Reference Value ◽  
Hashimoto's Thyroiditis ◽  
Common Disease ◽  
Iodine Prophylaxis ◽  
Iodine Supplementation ◽  
Expectant Mothers ◽  
Immunologic Activity ◽  
Antibody Levels

Abstract Purpose Hashimoto’s thyroiditis is a common disease that also affects pregnant women. We analyzed to what extent the inflammatory process of Hashimoto’s thyroiditis changes with iodine prophylaxis in pregnant women. The target for immunologic activity was levels of thyroid antibodies (TPO). Methods The data were collected retrospectively from 20 consecutive, pregnant patients who had been diagnosed with Hashimoto’s thyroiditis between 01.12.2012 and 01.12.2014 and had received iodine supplementation with 100 µg (n = 1) or 150 µg (n = 19). At least two measurements of TPO antibody levels taken during pregnancy and one after pregnancy were evaluated for each patient in the study group. Results At the end of pregnancy, the average TPO antibody level for the 20 patients studied was 137 IU/ml (+/–214 IU/ml), the lowest being 16 IU/ml and the highest 1000 IU/ml. Despite iodine prophylaxis, levels of TPO antibodies decreased in 18 patients during pregnancy, falling below the reference value of 35 IU/ml in 5 cases. However, in one patient TPO antibodies increased from 60 IU/ml to 237 IU/ml during pregnancy while in another, levels remained constant at 1000 IU/ml. Conclusion Iodine prophylaxis in pregnant women, taken at a dose of 100 or 150 μg daily was shown to have no negative systemic effects on Hashimoto’s thyroiditis in a group of pregnant women with increased TPO levels, and can therefore be recommended for expectant mothers, including those with this disease.

Determination of serum neopterin levels in patients with autoimmune thyroid diseases

2012 ◽  
Vol 153 (29) ◽  
pp. 1127-1131 ◽  
Author(s):  
Csaba Balázs ◽  
Boglárka Türke ◽  
Árpád Vámos
Keyword(s):  
Hashimoto’S Thyroiditis ◽  
Thyroid Stimulating Hormone ◽  
Hashimoto's Thyroiditis ◽  
Graves Disease ◽  
Important Indicator ◽  
Autoimmune Thyroid ◽  
Serum Neopterin ◽  
Antibody Levels ◽  
Stimulating Hormone

An elevated serum level of neopterin indicates the activation of the cellular immune system. Aim: The objective was to find a correlation in autoimmune thyroid patients between neopterin levels and the clinical stage of the disease and to examine whether neopterin can predict the relapse of the disease. Methods: Serum neopterin, thyroid stimulating hormone, free thyroxine, free triiodothyronine, anti-thyroglobulin and anti-thyroid peroxidase antibody levels were determined in 137 patients with Graves’ disease (in different stages), 25 with Hashimoto’s thyroiditis and 14 with toxic adenoma. Results: The neopterin levels were significantly higher in patients with Graves’ disease (hyper-, eu-, hypothyroidism and relapsed hyperthyroidism) and Hashimoto’s thyroiditis. Positive correlation was found between neopterin and anti-thyroglobulin and anti-tyhroid peroxidase antibody levels, but no correlation was detected between neopterin levels and thyroid hormones, thyroid stimulating hormone values and antibodies against thyroid stimulating hormone receptors. Conclusions: Higher level of serum neopterin reflects an underlying autoimmune process, and does not correlate with changes in thyroid hormone levels. Determination of neopterin level can be an important indicator in the exacerbation of autoimmune processes. Orv. Hetil., 2012, 153, 1127–1131.

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