scholarly journals Cytomorphologic spectrum of Hashimoto's thyroiditis and its clinical correlation: A retrospective study of 52 patients

CytoJournal ◽  
2014 ◽  
Vol 11 ◽  
pp. 9 ◽  
Author(s):  
Shirish S. Chandanwale ◽  
Charusheela R. Gore ◽  
Sunita A. Bamanikar ◽  
Nidhi Gupta ◽  
Kanika Gupta
Keyword(s):  
Thyroid Function ◽  
Hashimoto’S Thyroiditis ◽  
Lymphocytic Infiltration ◽  
Needle Aspiration ◽  
Clinical Findings ◽  
Hashimoto's Thyroiditis ◽  
Thyroid Peroxidase ◽  
Follicular Hyperplasia ◽  
Number Of Patients ◽  
Antibody Profile

Background: Hashimoto's thyroiditis (HT) is an autoimmune disease and it is more prevalent in Asians. The incidence of HT seems to be increasing in the recent times. It is one of the most common cause of hypothyroidism. The purpose of this study is to review the cytomorphologic spectrum of HT and correlate it with clinical findings including thyroid function and antibody profile. Materials and Methods: We retrospectively analyzed the fine-needle aspiration (FNA) features of 52 HT patients. Based on cytomorphologic features patients were categorized into three groups. Clinical findings including thyroid function and thyroid peroxidase (TPO) antibody profile were correlated with cytomorphologic features in all three groups. Results: Majority of the patients were females and in 2nd, 3rd and 4th decades. Diffuse goiter and thyroid hypofunction were the common findings. Significant number of patients had thyroid hyperfunction. Increased lymphocytes on the background and lymphocytic infiltration of thyroid follicular cell clusters in cytology smears were diagnostic of HT. The 32 patients showed elevated titers of TPO antibodies. In the early stages and mild form of the disease, results of thyroid function and anti TPO antibodies are quite variable. Conclusions: HT is a disease of young and middle age and mostly occur in females. Clinical findings alone may not be adequate for definitive diagnosis. FNA is the gold standard for diagnosis. In the presence of abundant colloid, follicular hyperplasia or co-existing neoplasm, careful interpretation of cytology smears should be done. Aspiration from more than one site minimizes the diagnostic pitfalls.

scholarly journals Cytomorphological Spectrum of Thyroiditis: A Review of 110 Cases

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Shirish S. Chandanwale ◽  
Rahul Nair ◽  
Anushree Gambhir ◽  
Supreet Kaur ◽  
Aditi Pandey ◽  
...  
Keyword(s):  
Thyroid Function ◽  
Hashimoto’S Thyroiditis ◽  
Thyroid Function Test ◽  
Lymphocytic Infiltration ◽  
Hashimoto's Thyroiditis ◽  
Thyroid Peroxidase ◽  
Thyroid Follicular Cell ◽  
Cell Clusters ◽  
Thyroid Peroxidase Antibodies ◽  
Function Test

Introduction. Different types of thyroiditis may share some parallel clinical and biochemical features. Timely intervention can significantly reduce morbidity and mortality. Aim. Aim of this study is to find the frequency of various thyroiditis, study the cytomorphological features and correlate with clinical findings including radiological findings, thyroid function test, and anti-thyroid peroxidase antibodies (Anti-TPO antibodies). Materials and Methods. The study included consecutive 110 cases of thyroiditis. Detailed cytomorphological features were studied and correlated with ultrasonography findings, thyroid function test, anti-thyroid peroxidase antibodies (anti-TPO) and histopathological features where thyroidectomy specimens were received for histopathological examination. Results. The majority were Hashimoto’s thyroiditis (n=100) and females (n=103). Other forms of thyroiditis were Hashimoto’s thyroiditis with colloid goiter (n=5), De Quervain’s thyroiditis (n=3), and one case each of postpartum thyroiditis and Hashimoto’s thyroiditis with associated malignancy. The majority of patients were in the age group of 21–40 (n=70) and the majority (n=73) had diffuse enlargement of thyroid. The majority of patients were hypothyroid (n=52). The serum anti-TPO antibodies were elevated in 47 patients out of 71 patients. In the 48 patients who underwent ultrasonography, 38 were diagnosed as having thyroiditis. The most consistent cytomorphological features seen in fine-needle aspiration smears of Hashimoto’s thyroiditis were increased background lymphocytes, lymphocytic infiltration of thyroid follicular cell clusters, and Hurthle cells. Conclusion. The diagnostic cytological features in Hashimoto’s thyroiditis are increased background lymphocytes, lymphocytic infiltration of thyroid follicular cell clusters, and Hurthle cells. FNAC remains the “Gold Standard” for diagnosing Hashimoto’s thyroiditis. Clinical history, thyroid function, and biochemical parameters are the key for diagnosis of other forms of thyroiditis.

scholarly journals Serum Selenium Status and Its Interrelationship with Serum Biomarkers of Thyroid Function and Antioxidant Defense in Hashimoto’s Thyroiditis

Antioxidants ◽  
2020 ◽  
Vol 9 (11) ◽  
pp. 1070
Author(s):  
Rahim Rostami ◽  
Sarmad Nourooz-Zadeh ◽  
Afshin Mohammadi ◽  
Hamid Reza Khalkhali ◽  
Gordon Ferns ◽  
...  
Keyword(s):  
Thyroid Function ◽  
Hashimoto’S Thyroiditis ◽  
Antioxidant Defense ◽  
Thyroid Volume ◽  
Hashimoto's Thyroiditis ◽  
Thyroid Peroxidase ◽  
Urinary Iodine Concentration ◽  
Serum Selenium ◽  
Se Deficiency ◽  
Se Status

Selenium (Se) deficiency has been implicated in the pathogenesis of Hashimoto’s thyroiditis (HT), although the available evidence is limited. The present study aimed to explore the interrelationships between serum Se status with measures of thyroid function and antioxidant defense in new cases of HT patients with hypoechogenic thyroid. HT patients (n = 49) and matched controls (n = 50) were recruited. Selenium, thyroid hormone panel, thyroid volume (TVol), glutathione (GSH), glutathione peroxidase3 (GPx3) activity, urinary iodine concentration (UIC), and urinary creatinine (Cr) were assessed. HT patients exhibited lower Se levels compared to controls (p < 0.001) with the rates of Se-deficient (<0.85 µmol/L) participants being 58.8% and 34%, respectively. Se-deficient patients exhibited higher thyroid stimulating hormone (TSH), Thyroid volume (TVol), thyroglobulin, antibody-titers, GPx3 activity and UIC/Cr compared to Se-sufficient patients (all p < 0.001). In the Se-deficient patients, inverse correlations were seen between Se-levels with TSH, TVol, and Thyroid peroxidase antibody (TPO-Ab) (all p < 0.001). This study is the first to uncover that coexisting Se-deficiency and elevated iodine in HT may enhance autoimmune reactions and accelerate the deterioration of thyroid function through oxidative stress. Our study also highlights the importance of optimal Se status in this disease, thus providing a rationale for the execution of intervention trials for the evaluation of the clinical benefits of antioxidant-status improvement in HT.

scholarly journals SAT-497 Conversion of Hashimoto’s Thyroiditis to Grave’s Disease: A Case Report

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Tayba S Wahedi ◽  
Najah Younes Douba
Keyword(s):  
Thyroid Function ◽  
Hashimoto’S Thyroiditis ◽  
Hashimoto's Thyroiditis ◽  
Thyroid Peroxidase ◽  
Autoimmune Thyroid ◽  
Grave’S Disease ◽  
Thyroid Uptake ◽  
Common Causes ◽  
Grave's Disease ◽  
Tsh Levels

Abstract Introduction: Hashimoto’s thyroiditis and Grave’s disease are common causes for autoimmune thyroid disease. Conversion from Grave’s disease to hypothyroidism have been previously reported in literature. But development of Grave’s disease after a long standing hypothyroidism rarely occurs.Case report: a 22 -year-old Saudi pregnant female patient, was diagnosed with subclinical hypothyroidism with positive anti -thyroid peroxidase antibodies (Anti-TPO) in 2009. She was started on thyroxin and eventually became euthyroid with normal TSH levels till 2016. During subsequent follow-ups, patient was increasingly complaining of palpitations, weight loss and fine tremors. Thyroid function revealed increasingly suppressed TSH levels and over-replacement was suspected. Thyroxin dose was then gradually reduced and finally stopped for few months. Yet her symptoms persisted. Repeated thyroid function showed suppressed TSH level and elevated T4, T3 levels in keeping with overt hyperthyroidism. Thyroid scan further confirmed the diagnosis with diffuse thyroid uptake suggestive of Grave’s disease.Patient was started on medical treatment initially, then successfully treated with radioactive ablation.Conclusion: Although it rarely occurs, possibility of conversion from hypothyroidism to hyperthyroidism should always be kept in mind while treating hypothyroid patients with persistent clinical or biochemical evidence of hyperthyroidism despite dose reduction.References:[1] McLachlan SM. Rapoport B. Thyrotropin-blocking autoantibodies and thyroid-stimulating autoantibodies: Potential mechanisms involved in the pendulum swinging from hypothyroidism to hyperthyroidism or vice versa. Thyroid. 2013;23(1):14-24.[2] Ohye H, Nishihara E, Sasaki I, et al. Four cases of Graves’ disease which developed after painful Hashimoto’s thyroiditis. Intern Med. 2006;45(6):385-9.

scholarly journals Neurofibromatosis Type 1 Associated with Hashimoto’s Thyroiditis: Coincidence or Possible Link

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Junaid Nabi
Keyword(s):  
Neurofibromatosis Type 1 ◽  
Hashimoto’S Thyroiditis ◽  
Neurofibromatosis Type ◽  
Lymphocytic Infiltration ◽  
Needle Aspiration ◽  
Left Lobe ◽  
Hashimoto's Thyroiditis ◽  
Autoimmune Thyroid ◽  
Hands And Feet

Introduction. Hashimoto's thyroiditis is a common form of chronic autoimmune thyroid disease (AITD) and often coexists with other autoimmune diseases, but Hashimoto’s thyroiditis associated with an autosomal dominant neurofibromatosis type 1 is exceedingly rare.Case Presentation. A 30-year-old Bengali woman presented to the OPD with complaints of aching pain and tingling sensation in her hands and feet. Physical examination revealed dysmorphic facies, nodular swelling in the neck, cafe-au-lait spots, and neurofibromas covering the entire surface of her body. Her thyroid hormones were within normal limits. Thyroid ultrasound revealed a cystic area in the left lobe of the gland, and ultrasound-guided fine needle aspiration cytology revealed lymphocytic infiltration of the gland, suggesting Hashimoto’s thyroiditis. High levels of autoimmune antibodies such as antithyroglobulin and antimicrosomal antibodies confirmed the diagnosis.Conclusion. When encountered with a patient of Neurofibromatosis type 1, a physician should be careful about the possibility of a concomitant autoimmune disease. Clinical presentation of neurofibromatosis and Noonan syndrome often overlaps and recent studies have implicated a mutation in NF1 gene in the etiology of NFNS. More extensive reports and further investigations of such patients having combination of neurofibromatosis type 1 and autoimmune thyroiditis will certainly provide better understanding of this link in the near future.

scholarly journals The Link between Graves’ Disease and Hashimoto’s Thyroiditis: A Role for Regulatory T Cells

Endocrinology ◽  
2007 ◽  
Vol 148 (12) ◽  
pp. 5724-5733 ◽  
Author(s):  
Sandra M. McLachlan ◽  
Yuji Nagayama ◽  
Pavel N. Pichurin ◽  
Yumiko Mizutori ◽  
Chun-Rong Chen ◽  
...  
Keyword(s):  
T Cells ◽  
Antibody Response ◽  
Hashimoto’S Thyroiditis ◽  
Lymphocytic Infiltration ◽  
Hashimoto's Thyroiditis ◽  
Thyroid Peroxidase ◽  
Graves Disease ◽  
Wild Type ◽  
Treg Depletion ◽  
A Subunit

Hyperthyroidism in Graves’ disease is caused by thyroid-stimulating autoantibodies to the TSH receptor (TSHR), whereas hypothyroidism in Hashimoto’s thyroiditis is associated with thyroid peroxidase and thyroglobulin autoantibodies. In some Graves’ patients, thyroiditis becomes sufficiently extensive to cure the hyperthyroidism with resultant hypothyroidism. Factors determining the balance between these two diseases, the commonest organ-specific autoimmune diseases affecting humans, are unknown. Serendipitous findings in transgenic BALB/c mice, with the human TSHR A-subunit targeted to the thyroid, shed light on this relationship. Of three transgenic lines, two expressed high levels and one expressed low intrathyroidal A-subunit levels (Hi- and Lo-transgenics, respectively). Transgenics and wild-type littermates were depleted of T regulatory cells (Treg) using antibodies to CD25 (CD4+ T cells) or CD122 (CD8+ T cells) before TSHR-adenovirus immunization. Regardless of Treg depletion, high-expressor transgenics remained tolerant to A-subunit-adenovirus immunization (no TSHR antibodies and no hyperthyroidism). Tolerance was broken in low-transgenics, although TSHR antibody levels were lower than in wild-type littermates and no mice became hyperthyroid. Treg depletion before immunization did not significantly alter the TSHR antibody response. However, Treg depletion (particularly CD25) induced thyroid lymphocytic infiltrates in Lo-transgenics with transient or permanent hypothyroidism (low T4, elevated TSH). Neither thyroid lymphocytic infiltration nor hypothyroidism developed in similarly treated wild-type littermates. Remarkably, lymphocytic infiltration was associated with intermolecular spreading of the TSHR antibody response to other self thyroid antigens, murine thyroid peroxidase and thyroglobulin. These data suggest a role for Treg in the natural progression of hyperthyroid Graves’ disease to Hashimoto’s thyroiditis and hypothyroidism in humans.

scholarly journals Amelioration of iodine supply is notably associated with thyroid function in healthy subjects and in patients with euthyroid Hashimoto’s thyroiditis

2016 ◽  
Vol 85 (10) ◽  
Author(s):  
Nadja Novak ◽  
Ajda Biček ◽  
Katja Zaletel ◽  
Simona Gaberšček
Keyword(s):  
Thyroid Function ◽  
Hashimoto’S Thyroiditis ◽  
Healthy Subjects ◽  
Hashimoto's Thyroiditis ◽  
Thyroid Peroxidase ◽  
Free Triiodothyronine ◽  
Tertiary Referral Centre ◽  
Salt Iodization ◽  
Iodine Supply ◽  
First Time

Background: Our aim was to establish how healthy subjects (HS) and patients with euthyroid Hashimoto's thyroiditis (EuHT) faced the increase in mandatory salt iodization in Slovenia in 1999 from previous 10 mg of potassium iodide to 25 mg per kg since data about thyroid function with respect to iodine supply are scant.Methods: In this retrospective study we reviewed records of 24,899 patients referred for the first time between 1995 and 2002 to our tertiary referral centre with a stable catchment area for more than 20 years. HS were negative and patients with EuHT positive for thyroid peroxidase antibodies and/or thyroglobulin antibodies. Thyrotropin (TSH), free thyroxine (fT4), and free triiodothyronine (fT3) levels were obtained. The fT4/fT3 ratio was calculated.Results: In the period 1995-1998, 917 HS had significantly lower fT4/fT3 ratio than 644 HS in the period 1999-2002 (2.6±0.6 and 2.9±0.9, respectively, p<0.001) on account of significantly higher fT3 (median 5.7 and 5.2 pmol/L, p<0.001). Similarly, in 1995-1998, 482 patients with EuHT had a lower fT4/fT3 ratio than 846 EuHT in 1999-2002 (2.4±0.6 and 2.8±0.7, respectively, p<0.001) on account of significantly higher fT3 (median 5.8 and 4.9, respectively, p=0.018). HS had a higher fT4/fT3 ratio than patients with EuHT in 1995-1998 but not in 1999-2002 (p<0.001 and p=0.206, respectively).Conclusions: Amelioration of iodine supply is associated with an increase in the fT4/fT3 ratio on account of lower fT3, and with a similar thyroid function in HS and in patients with EuHT.

scholarly journals Association of Hashimoto's thyroiditis with thyroid cancer

2014 ◽  
Vol 21 (6) ◽  
pp. 845-852 ◽  
Author(s):  
G Azizi ◽  
J M Keller ◽  
M Lewis ◽  
K Piper ◽  
D Puett ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Hashimoto’S Thyroiditis ◽  
Elevated Serum ◽  
Multivariate Logistic Regression Analysis ◽  
Needle Aspiration ◽  
Hashimoto's Thyroiditis ◽  
Thyroid Peroxidase ◽  
Thyroid Peroxidase Antibody ◽  
And Gender ◽  
Benign Nodules

This prospective study investigates the relationship between Hashimoto's thyroiditis (HT) and thyroid cancer (TC) in patients with thyroid nodules (TNs). We prospectively examined 2100 patients with 2753 TNs between January 5, 2010 and August 15, 2013. A total of 2023 patients with 2669 TNs met the inclusion criteria of TN ≥5 mm and age ≥18 years. Each patient had blood drawn before fine-needle aspiration biopsy (FNAB) for the following measurements: TSH, free thyroxine, free tri-iodothyronine, thyroid peroxidase antibody (TPOAb), and antithyroglobulin antibody (TgAb). Diagnosis of TC was based on pathology analysis of thyroidectomy tissue. The associations of TC with the independent variables were determined by univariate and multivariate logistic regression analysis and reported as adjusted odds ratio (OR) with 95% CI. A total of 248 malignant nodules were found in 233 patients. There was an association of TC with both increased serum TgAb concentration and age<45 years. An elevated serum TgAb concentration was found in 10.2% of patients (182 of 1790) with benign nodules as compared with 20.6% of patients (48 of 233) with malignant nodules (P≤0.0001). TgAb (OR=2.24: CI=1.57, 3.19) and TSH ≥1 μIU/ml (OR (95% CI)) OR: 1.49 (1.09, 2.03) were significant predictors of TC in multivariate analysis controlling for age and gender. TC was not associated with serum concentrations of TPOAb. In patients with TN, elevated serum concentration of TgAb and TSH ≥1 μIU/ml are independent predictors for TC. The association between HT and TC is antibody specific.

Recovery of thyroid function with a decreased titre of antimicrosomal antibody in a hypothyroid man with Hashimoto's thyroiditis

1983 ◽  
Vol 102 (4) ◽  
pp. 531-534 ◽  
Author(s):  
Makiko Yamamoto ◽  
Kazuro Kaise ◽  
Hirofumi Kitaoka ◽  
Katsumi Yoshida ◽  
Nobuko Kaise ◽  
...  
Keyword(s):  
Hashimoto’S Thyroiditis ◽  
Serum Levels ◽  
Hashimoto's Thyroiditis ◽  
Thyroid Peroxidase ◽  
Normal Range ◽  
Surgical Biopsy ◽  
Low Levels ◽  
Serum Thyroid Hormones ◽  
Antimicrosomal Antibody ◽  
Serum Tsh

Abstract. A 36 year old man with a diffuse goitre, signs of mild hypothyroidism, strikingly low levels of T4 (0.9 μg/dl) and T3 (24 ng/dl), elevated TSH (140 μU/ml) and elevated microsomal haemagglutination antibody (MCHA, 1:409 600), subsequently became non-goitrous and euthyroid with a decreased titre of antimicrosomal antibody without any medication. At the time of surgical biopsy, serum levels of T4 and T3 had risen to the normal range (4.6 μg/dl and 73 ng/dl, respectively), serum TSH had decreased to 30 μU/ml and the titre of MCHA to 1:25 600. Thyroid specimens showed Hashimoto's thyroiditis. The activity of thyroid peroxidase (TPO) was normal. The latest examination, 1 year and 3 months after initial evaluation, showed that the patient remained euthyroid with no goitre, that serum thyroid hormones were within the normal range (T4 7.7 μg/dl and T3 97 ng/dl), and that TSH was not detectable. The titre of MCHA decreased strikingly to 1:400.

scholarly journals Relationship Between Thyroid Hormonal Status in Patients with a Hypothyroid Form of Hashimoto’s Thyroiditis and Iodine Concentrations in Drinking Water

2021 ◽  
Author(s):  
Olha Kasiyan ◽  
Halyna Tkachenko ◽  
Natalia Kurhaluk ◽  
Svitlana Yurchenko ◽  
Alek Manenko
Keyword(s):  
Hashimoto’S Thyroiditis ◽  
Iodine Concentration ◽  
Iodine Intake ◽  
Thyroid Stimulating Hormone ◽  
Hashimoto's Thyroiditis ◽  
Thyroid Peroxidase ◽  
Supply Network ◽  
Thyroid Status ◽  
Thyroglobulin Antibodies ◽  
Regressive Analysis

AbstractThe current study aimed to identify correlative and regressive dependencies between the water iodine concentration and the levels of TSH (thyroid-stimulating hormone), thyroglobulin antibodies (TgAbs), and thyroid peroxidase (TPOAb) in the serum of 168 in patients (34 men and 134 women) with a hypothyroid form of Hashimoto’s thyroiditis who use water from the supply network and individual wells. Based on the water iodine concentration, low and moderate degrees of iodine endemia in the location of the patients were determined. In the groups of men and women using water from different water supply sources, there were direct correlations between the water iodine concentrations and the TgAbs and TPOAb titers as well as an inverse dependence between iodine and TSH levels. Multivariate regressive analysis indicated that TgAb and TSH in the group of women using water from a supply network and TPOAb titers in the group of women using well water were independent factors associated with water iodine concentrations. Statistically significant correlations and regressive dependencies between the water iodine concentrations and the biomarkers of the thyroid status of the patients indicate the risk of Hashimoto’s thyroiditis progression, especially among women with additional iodine intake.

Salivary gland function in women with Hashimoto’s thyroiditis without xerostomia and the correlation with auto-thyroid antibodies

2020 ◽  
Author(s):  
Xiao-an Pang ◽  
Zhi-xiao Wei ◽  
Jun-hong Li ◽  
Xiao-qi Pang
Keyword(s):  
Salivary Gland ◽  
Hashimoto’S Thyroiditis ◽  
Thyroid Stimulating Hormone ◽  
Hashimoto's Thyroiditis ◽  
Control Group ◽  
Thyroid Peroxidase ◽  
Thyroid Autoantibody ◽  
Submandibular Glands ◽  
Quantitative Parameters ◽  
Salivary Function

Abstract Background Hashimoto’s thyroiditis (HT) may cause salivary dysfunction in patients resulting in xerostomia, but little is known about changes in salivary function in patients with no obvious dry mouth symptoms. In this study we assessed salivary function in women with HT, who had not experienced xerostomia and, for the first time, evaluated the effects of thyroid auto-antibodies on this function. Methods Sixty consecutive subjects were included, comprising 32 women (mean age, 36 ± 12 years) diagnosed with HT accompanied by differentiated thyroid cancer (DTC) in the study group (HT group), along with a control group (DTC group) of 28 women (mean age, 40 ± 12 years) diagnosed with DTC only. Salivary gland scintigraphy was used to assess salivary function with the semi-quantitative parameters of maximum absorption ratio and maximum secretion ratio, the decrease of which indicate impaired salivary function. Moreover, the HT and DTC groups were divided into four subgroups (Anti– HT, Anti+ HT, Anti– DTC, and Anti+ DTC), based on the presence of anti-thyroid peroxidase antibody (TPOAb) and anti-thyroglobulin antibody (TgAb). Finally, salivary gland semi-quantitative parameters were correlated with levels of thyroid-stimulating hormone (TSH), TGAb, and TPOAb in the HT and DTC groups. Results None of the semi-quantitative parameters examined in parotid or submandibular glands differed significantly between the HT and DTC groups. However, the maximum secretion ratio for the parotid and submandibular glands were significantly different in the subgroup comparison (p < 0.05). Furthermore, the TgAb, TPOAb, and TSH values correlated significantly with salivary excretive function (p ≤ 0.05). Conclusion Women with HT without xerostomia may not have salivary functional impairment during hypothyroidism. Serum thyroid autoantibody and TSH levels may mainly influence salivary excretive function but not uptake function.

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