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Chronic lymphocytic
thyroiditis
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- Hashimoto's Thyroiditis is the most common form of thyroid disease in the United States, and it is also the most common form of Thyroiditis. It tends
to run in families, and is much more common in women than
men. In this condition, the thyroid gland typically becomes
enlarged, causing the patient to develop Hypothyroidism.
Treatment is usually with thyroid hormone replacement.
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- The thyroid gland is typically
enlarged all over, not just in one area. It is usually firm
and not tender to touch.
- In some cases, the thyroid gland
may actually shrink.
- If the thyroid enlarges, it may put
pressure on other structures in the neck.
- Most often, people with Hashimoto's Thyroiditis suffer
from symptoms of Hypothyroidism (fatigue, lethargy,
decreased metabolic rate).
- In the case of acute severe infection, the thyroid gland may suddenly release its store of thyroid hormone, temporarily causing symptoms of Hyperthyroidism (Subacute Thyroiditis).
- Others may develop Grave's Disease , which also causes Hyperthyroidism.
- People with Hashimoto's disease may also suffer from chronic fatigue, dry eyes, dry mouth, and/or Depression. Others may have a mild form of Myasthenia Gravis,
which causes the muscles of the eye to become weak. Some of
these symptoms may continue even after the Hashimoto's
disease has been treated.
- Many may have this disease and
never have any symptoms at all.
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- Most people with Hashimoto's Thyroiditis have
increased levels of antithyroglobulin antibodies and
antithyroid peroxidase antibodies.
- Depending on whether the patient is
hypo- or hyperthyroid, the TSH (thyroid stimulating hormone)
may be increased, decreased, or normal.
- Most often, T4 and T3 uptake is
usually low.
- A Nuclear scan with
radioactive iodine may be high.
- If the diagnosis is uncertain, and
if there is any suspicion of cancer, a biopsy of the thyroid
gland is advised.
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- Treatment for Hashimoto's Thyroiditis --
if the patient is hypothyroid, or if they have an enlarged Goiter (swelling in the
front part of the neck, aka "struma"), Levothyroxine (a
thyroid hormone replacement) is administered.
- If the patient is not hypothyroid
and the thyroid is not enlarged, he may be monitored without
medication, but will need to have his thyroid hormone levels
followed. Close follow-up with the doctor is advised as
eventually Hypothyroidism may develop.
- Long-term prognosis is very good.
Most people with the disease can be easily
treated.
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- Hashimoto's Thyroiditis may be associated with Addison's Disease, hypoparathyroidism, diabetes, pernicious anemia, biliary Cirrhosis, or
Vitiligo. It is important that people with this disease be
evaluated for these other disorders.
- If only part of the thyroid gland is enlarged, cancer and Lymphoma must be
ruled out.
- If the thyroid gland is allowed to become enlarged, it may cause paralysis of the vocal cords, and difficulty swallowing and breathing.
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