Autoimmune thyroiditis symptoms
Autoimmune thyroiditis is one of the most common thyroid disease.Among the population of various countries autoimmune thyroiditis occurs in 0.1 - 1.2% (in children) - 6-11% (in women older than 60 years) of cases.At the same time, thyroid antibodies circulating in the blood can be detected in 10-15% of healthy individuals.The ratio of the number of ill men and women is 1: 4 1: 10. Autoimmune thyroiditis is one of the most common autoimmune diseases.For the first time the disease has been described by Hashimoto in 1912. There are two major forms of autoimmune thyroiditis : hypertrophic (Hashimoto) and atrophic (primary myxedema).
The disease develops in the genetically determined defect of the immune system.As a result, a defect in the blood cells to produce antibodies own thyroid, under the influence of which the cells are destroyed.
Autoimmune thyroiditis tends to manifest itself in the form of family forms.Observing the fraternal twins indicates the simultaneous occurrence of their disease in 3-9%
During the development of the autoimmune process in patients with autoimmune thyroiditis thyroid function undergoes numerous changes with practically mandatory outcome in hypothyroidism, t. E. The condition that develops during long-term persistent deficiency of thyroid hormones.Among people with autoimmune thyroiditis most are those in which the disease is in the mild form, or even without any specific symptoms of hypothyroidism.In some parts of autoimmune thyroiditis patients with early disease of hyperthyroidism, there may be (a condition with an excess of body thyroid hormones).The development of such a condition associated with tissue decay process due to thyroid exposure to the antibodies and the blood enters the large number of previously synthesized hormone.Another possible cause temporary hyperthyroidism (hashitoksikoz) may be the presence of antibodies that stimulate the formation of thyroid hormones.Hypothyroidism caused by autoimmune thyroiditis, is generally regarded as an irreversible condition, but there are few reports that even with long-existing hypothyroidism, thyroid function can return to normal spontaneously.In some cases, it is developing a state of increased production of thyroid hormones.Autoimmune thyroiditis is a benign disease of the thyroid gland.Transforming it into a malignant pathology is unlikely, except for very rare lymphoma of the thyroid gland.Moreover, in patients with autoimmune thyroiditis occurs surroundings portion thyroid cancer of blood cells, providing a protective effect, reducing the incidence of tumor metastasis.
In most cases, autoimmune thyroiditis first appears between 30 and 60 years.The course of the disease for a long period and at the beginning - asymptomatic.Hashitoksikoz (hyperthyroidism in patients with autoimmune thyroiditis) may be difficult to distinguish from diffuse toxic goiter, because in fact, and in either case can be determined by an increase of the thyroid gland, and the same type of change detected by ultrasound.In this case study may help specific antibodies.In addition, long-term, more than six months, during thyrotoxicosis evidence in favor of diffuse toxic goiter.In hypertrophic form of the disease in the neck goiter determined.In case of formation in the interior of nodules there is a need to eliminate their malignant transformation that can occur in patients with autoimmune thyroiditis.In some cases, may be affected and the organ of vision in patients with autoimmune thyroiditis.
Autoimmune thyroiditis is a disease that can only be detected in the presence of characteristic symptoms and results of laboratory and instrumental methods.None of the methods, even the most informative in itself does not allow the diagnosis of autoimmune thyroiditis.In general, the more there is the characteristic manifestations and laboratory and instrumental signs of the disease, the more likely the presence of autoimmune thyroiditis.
In humans with autoimmune thyroiditis usually have elevated antibody levels of thyroid hormones.The large number of antibodies in the blood is a major sign of a presence, or high risk of developing autoimmune thyroid disease.Note that a moderate increase in the level of antibodies to the hormones of the thymus occurs in approximately 20% of healthy people and has no particular meaning.Thus, the diagnosis of autoimmune thyroiditis only on the basis of detection of a small increase in the level of antibodies is a mistake.
needle biopsy can also be used for the detection of autoimmune thyroiditis, as well as diseases with similar symptoms.The most typical indication for this type of study is a combination of autoimmune thyroiditis with nodules in the thyroid gland to exclude cancer.However, the detection of typical data of laboratory and instrumental studies clearly indicate the presence of autoimmune thyroiditis, the thyroid gland is not necessary to biopsy.
Even though hypothyroidism is autoimmune thyroiditis occurs when no symptoms, it is in any case leads to the activation of the adrenal glands.At the same time, from the time they are released hormones into the blood, which is accompanied by recurrent attacks of palpitations, sweating, trembling hands, the feeling of fear.The collection of such manifestations of this disease is often referred to as "panic attacks."Often, the mention of such manifestations makes doctors look for such diseases as hyperthyroidism.In hypothyroidism observed a moderate decrease of prolactin (a female hormone), which often leads to the formation of polycystic ovaries.
treatment. The vast majority of patients with autoimmune thyroiditis is conducted conservative treatment.The thyrotoxic phase of autoimmune thyroiditis should theoretically be limited to receiving funds to facilitate the disappearance of all symptoms of the disease (symptomatic agents).Subsequently, it is necessary to include in the treatment of thyroid hormone drugs (replacement therapy).In practice the thyrotoxic phase of autoimmune thyroiditis is usually regarded as a manifestation of a diffuse toxic goiter, due to which is assigned a different treatment.
In most cases, treatment of autoimmune thyroiditis is conservative, but there are situations when it appears necessary to carry out the operation.Indications for surgical treatment of patients with hypertrophic form of autoimmune thyroiditis are a combination of autoimmune thyroiditis with cancer processes in the thyroid gland, as well as the large size of goiter with symptoms of compression of adjacent organs.
in the pathogenesis of most diseases of the thyroid gland (Graves' disease, toxic nodular goiter, primary hypothyroidism and others.) The crucial role played by autoimmune processes, so their diagnosis requires the determination of anti-thyroid antibodies.Currently, diagnosis using the definition:
- tireoidmikrosomalnyh autoantibodies;
- antibodies to thyroglobulin;
- autoantibodies tireoidperoksidaze.