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14-September-2008 18:02:46 - Hashimoto's thyroiditis February 2008 Hashimoto's thyroiditis Classification and external resources Histology ICD-10 E06.3 ICD-9 245.2 OMIM 140300 DiseasesDB 5649 eMedicine med/949 MeSH D050031 Hashimoto's thyroiditis or chronic lymphocytic thyroiditis is an autoimmune disease where the body's own T-cells attack the cells of the thyroid. It was the first disease to be recognised as an autoimmune disease. 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. Contents 1 Causes 2 Presentation 3 Treatment 4 Eponym 5 Symptoms 6 Possible complications 7 References 8 External links 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 results in hypothyroidism, although in its acute phase, it can cause a transient hyperthyroidism thyrotoxic state known as hashitoxicosis. 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 might include symptoms of hyperthyroidism in the early phase of the disease, and then hypothyroidism. Weight gain, depression, mania, fatigue, panic attacks, bradycardia, tachycardia, high cholesterol, reactive hypoglycemia, constipation, migraines, memory loss, infertility and hair loss are a few possible symptoms. Hashimoto's thyroiditis is often misdiagnosed as bipolar disorder and, less frequently, as anxiety disorder. Testing for antithyroid antibodies can resolve any diagnostic difficulty. 1 Treatment Hypothyroidism caused by Hashimoto's Thyroiditis is treated with thyroid hormone replacement. A small pill taken once a day should be able to keep the thyroid hormone levels normal. This medicine will, in most cases, need to be taken for the rest of the patient's life. Eponym The explanation board of Hashimoto Dori in Kyushu University The explanation board of Hashimoto Dori in Kyushu University 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,2 who first described the symptoms in 1912 in a German publication3. Symptoms Common symptoms in people with thyroiditis are: Enlarged thyroid area non-tender Weight gain Frequent nausea Tiredness Possible depression Possible complications If untreated for an extended period, Hashimoto's thyroiditis may lead to muscle failure, including possible heart failure. References ^ AJ Giannini. The Biological Foundations of Clinical Psychiatry. New Hyde Park, NY. Medical Examination Publishing Co., 1986. ^ Hakaru Hashimoto at Who Named It ^ 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 Hashimoto's Thyroiditis Alternative Health Solutions for Thyroid Autoimmunity Elaine Moore Graves' and Autoimmune Disease Education v d e Endocrine pathology: endocrine diseases E00-35, 240-259 Pancreas/ glucose metabolism Diabetes mellitus types: type 1, type 2, MODY, complications: coma, angiopathy, ketoacidosis, nephropathy, neuropathy, retinopathy Hypoglycemia - Hyperinsulinism - Zollinger-Ellison syndrome - insulin receptor Rabson-Mendenhall syndrome - Insulin resistance Hypothalamic/ pituitary axes Pituitary Hyperpituitarism Acromegaly, Hyperprolactinaemia, SIADH Hypopituitarism Sheehan's syndrome, Kallmann syndrome, Growth hormone deficiency, Diabetes insipidus Adiposogenital dystrophy - Empty sella syndrome - Pituitary apoplexy - ACTH deficiency Thyroid Hypothyroidism Iodine deficiency, Cretinism, Congenital hypothyroidism, Goitre, Myxedema Hyperthyroidism Graves disease, Toxic multinodular goitre, Teratoma with thyroid tissue or Struma ovarii Thyroiditis De Quervain's thyroiditis, Hashimoto's thyroiditis, Riedel's thyroiditis Euthyroid sick syndrome - Thyroid hormone resistance - Thyroid nodule Parathyroid Hypoparathyroidism Pseudohypoparathyroidism - Hyperparathyroidism Primary, Secondary, Tertiary Adrenal Adrenocortical hyperfunction: Cushing's syndrome Nelson's syndrome, Pseudo-Cushing's syndrome - Hyperaldosteronism Conn syndrome, Bartter syndrome CAH Lipoid, 3β, 11β, 17α, 21α Adrenal insufficiency Addison's disease, Waterhouse-Friderichsen syndrome - Hypoaldosteronism Gonads ovarian Polycystic ovary syndrome, Premature ovarian failure testicular 5-alpha-reductase deficiency, 17-beta-hydroxysteroid dehydrogenase deficiency general Hypogonadism, Delayed puberty, Precocious puberty Other Androgen insensitivity syndrome - Autoimmune polyendocrine syndrome - Carcinoid syndrome - Gigantism - Short stature Laron syndrome, Psychogenic dwarfism - Multiple endocrine neoplasia 1, 2 - Progeria - Woodhouse-Sakati syndrome - thymus Abscess of thymus, Thymus hyperplasia see also congenital, neoplasia v d e Immune disorders: Hypersensitivity and autoimmune diseases I IgE Allergy Food allergy · Atopy Atopic dermatitis · Anaphylaxis · Urticaria · Hay fever II IgM, IgG ADCC · Pernicious anemia · Hemolytic disease of the newborn · Penicillin allergy autoimmune, cytotoxic: Idiopathic thrombocytopenic purpura · Bullous pemphigoid · Autoimmune hemolytic anemia · Goodpasture's syndrome · Pemphigus vulgaris · Rheumatic fever autoimmune, type 5/receptor: Graves' disease · Myasthenia gravis III Immune complex Serum sickness · Arthus reaction · Hypersensitivity vasculitis · Reactive arthritis · Henoch-Schönlein purpura · Farmer's lung · Post-streptococcal glomerulonephritis autoimmune: Systemic lupus erythematosus · Subacute bacterial endocarditis IV T-cells Contact dermatitis · Cell-mediated immunity · Mantoux test · Graft-versus-host disease autoimmune: Temporal arteritis · Diabetes mellitus type 1 · Hashimoto's thyroiditis · Guillain-Barré syndrome · Multiple sclerosis · Rheumatoid arthritis · Coeliac disease Unknown/ multiple Autoimmune hepatitis · Transplant rejection Retrieved from http://en..org/wiki/Hashimoto%27s_thyroiditis Categories: Autoimmune diseases | Thyroid diseaseHidden category: Articles needing additional references from February 2008 Views Article Discussion this page History Personal tools Log in / create account Navigation Main page Contents Featured content Current events Random article Search Go Search Interaction Community portal Recent changes Contact Donate to Help Toolbox What links here Related changes Upload file Special pages Printable version Permanent link Cite this page Languages Deutsch Español Français Italiano עברית 日本語 Polski Português РуÑ?Ñ?кий Svenska ä¸æ–‡ This page was last modified on 11 September 2008, at 15:1
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