A study of autoimmune thyroiditis in thyroid swellings
DOI:
https://doi.org/10.18203/2349-2902.isj20195389Keywords:
Thyroid swellings, Autoimmune thyroiditis, Autoimmune diseasesAbstract
Background: The present study aimed to study occurrence, clinical presentation, biochemical status and management strategies, complications and clinical improvement during follow up of autoimmune thyroiditis in patients presenting with thyroid swellings.
Methods: The prospective study was carried out from 18 months i.e., from January 2016-June 2017 at Department of General Surgery, Bhaskar Medical College, Yenkapally, Moinabad, Ranga Reddy, Hyderabad, Telangana, India. A detailed clinical history was taken from all patients followed by clinical examination. Following investigations were performed on all patients. Haematological investigations (T3, T4, TSH, thyroid antibodies), fine needle aspiration cytology, Histopathology report and Thyroid scan. Data was analyzed using SPSS software (V.23.0).
Results: The occurrence of autoimmune thyroiditis was determined in 15 (22.73%) patients. Most of the patients were females. About clinical presentation; goitre was present in all 66 (100%) cases. In group A; following complications were seen at the time of 1 year follow up: 1(6.67 %) patient developed Graves disease, 2 (13.33%) patients who were initially euthyroid developed hyperthyroidism and thyroid lymphoma was detected in 2 (13.33%) patients. In group B, following complications were seen at the time of 1 year follow up; 4 (7.84%) patients who were initially euthyroid developed hyperthyroidism and 2 (3.92%) patients developed follicular thyroid carcinoma and mortality observed was 1 (1.96%) patient.
Conclusions: All cases of goitre should thus be comprehensively evaluated even though they might be asymptomatic.
References
Kumar V, Abbas A, Fausto N, Aster J. Robbins and Cotran Pathologic Mechanisms of Disease. The endocrine system. 8th ed. Philadelphia, USA: Elsevier; 2010: 1113.
Dorairajan N, Akshaya K. Total versus subotal thyroidectomy in grave’s disease: a retrospective analysis. Indian J Surg. 2002;64(6):506-10.
Vanderpump MP, Tunbridge WM, French JM, Appleton D, Bates D, Clark F, et al. The incidence of thyroid disorders in the community: a twenty-year follow-up of the Whickham Survey. Clin Endocrinol. 1995;43(1):55-68.
Hadj-Kacem H, Rebuffat S, Mnif-F Eki M, Belguith-Maalej S, Ayadi H, P’eraldi-Roux S. Autoimmune thyroid diseases: genetic susceptibility of thyroid-specific genes and thyroid autoantigens contributions. Int J Immunogenetics. 2009;36(2):85-96.
Weetman AP, McGregor AM. Autoimmune thyroid disease: further developments in our understanding. Endocrine Reviews. 1994;15(6):788-830.
Eguchi K, Matsuoka N, Nagataki S. Cellular immunity in autoimmune thyroid disease. Bailliere’s Clin Endocrinol Metab. 1995;9(1):71-94.
Huber A, Menconi F, Corathers S, Jacobson EM, Tomer Y. Joint genetic susceptibility to type 1 diabetes and autoimmune thyroiditis: from epidemiology to mechanisms. Endocrine Reviews. 2008;29(6):697-725.
Tomer Y, Huber A. The etiology of autoimmune thyroid disease: a story of genes and environment. J Autoimmun. 2009;32(3-4):231-39.
Hashimoto H. Zyr Kenntniss der lymphomatosen veranderung der schilddruse (strauma lymphomatosa). Archiv F¨ur Klinische Chirurgie. 1912;97:219-48.
Iddah MA, Macharia BN, Ng’wena AG, Keter A, Ofulla AVO. Thryroid hormones and hematological indices levels in thyroid disorders patients at Moi teaching and referral hospital, Western Kenya. ISRN Endocrinol. 2013;385940.
Canaris GJ, Manowitz NR, Mayor G, Ridgway EC. The Colorado thyroid disease prevalence study. Arch Internal Med. 2000;160(4):526-34.
Chiovato L, Bassi P, Santini F, Mammoli C, Lapi P, Carayon P, et al. Antibodies producing complement-mediated thyroid cytotoxicity in patients with atrophic or goitrous autoimmune thyroiditis. J Clin Endocrinol Metab. 1993;77(6):1700–5.
Marwaha RK, Tandon N, Karak AK, Gupta N, Verma K, Kochupillai N. Hashimoto’s thyroiditis: countrywide screening of goitrous healthy young girls in postiodization phase in India. J Clin Endocrinol Metab. 2000;85:3798-802.
Thomas T, Sreedharan S, Khadilkar UN, Deviprasad D, Kamath MP, Bhojwani KM, et al. Clinical, biochemical and cytomorphologic study on Hashimoto’s thyroiditis. Indian J Med Res. 2014;140:729-35.
Pradeep PV, Ragavan M, Ramakrishna BA, Jayasree B, Skandha SH. Surgery in Hashimoto's thyroiditis: indications, complications, and associated cancers. J Postgrad Med. 2011;57(2):120-2.
Singh N, Kumar S, Negi VS, Siddaraju N. Cytomorphologic study of Hashimoto's thyroiditis and its serologic correlation: a study of 150 cases. Acta Cytol. 2009;53:507–16.
Pearce EN, Farwell AP, Braverman LE. Thyroiditis. N Engl J Med. 2003;348: 2646-55.
