Thyroiditis (full name of autoimmune thyroiditis, Hashimoto's thyroiditis), sometimes called lymphomatous thyroiditis, there is nothing but inflammation of the thyroid gland, resulting in which are formed in the body cells and antibodies that begin to deal with their own cells of the thyroid gland, resulting in cancer cells begin die.
Statistics domestic MOH found that autoimmune thyroiditis is nearly 30% of all thyroid diseases. This disease usually appears in people aged 40-50 years, although in recent years the disease "rejuvenated" and more often diagnosed in young people, and sometimes - and in children.
Kinds
Autoimmune thyroiditis can be divided into several diseases, even though they all have the same nature:
1. Thyroiditis (aka -'s thyroiditis, formerly bore the name autoimmune Hashimoto's thyroiditis or Hashimoto's) It develops due to a sharp increase in specific antibodies and form lymphocytes (T cells) which destroy cells begin thyroid gland. As a result, the thyroid gland is sharply reduces the amount of hormones produced. This phenomenon is at the medical name
hypothyroidism. The disease has a pronounced genetic form and the relatives of the patient are very common diseases diabetes diabetes and various forms of destruction of the thyroid gland.2. Postpartum thyroiditis is best understood from the fact that the disease occurs more frequently than others. Disease occurs due to overload of the female body during pregnancy, as well as in the case of an existing predisposition. It is this relationship and leads to the fact that postpartum thyroiditis turns into a destructive autoimmune thyroiditis.
3. Silent (silent) postpartum thyroiditis similar, but the reason for its occurrence in patients not yet been identified.
4. Cytokine-induced thyroiditis may occur in patients with hepatitis C or blood disorder in the case of treating these diseases with interferon.
According to clinical manifestations, and depending on changes in the size of thyroid autoimmune thyroiditis are divided into the following forms:
- Latent - when the clinical symptoms are absent, but there are signs of immunological. In this form of thyroid disease or normal size or slightly increased. Its features are not broken and does not experience any seal gland in the body;
- Hypertrophic - when violated in thyroid function and its dimensions are increased, forming a goiter. If the increase in size of the prostate throughout the volume of uniform, it is a diffuse form of the disease. If the nodes are formed in the body of the prostate, the disease called nodular form. However, there are cases of simultaneous combination of both the above forms;
- Atrophic - when the size of the thyroid gland is normal or even reduced, but the amount of hormones produced by sharply reduced. This picture of the disease is common in the elderly, and young people - only in case of their exposure to radiation.
Causes
Even with a genetic predisposition for the occurrence and development of thyroiditis, additional factors that trigger the occurrence of the disease:
- acute respiratory viral disease;
- foci of chronic diseases (sinus, tonsils, carious teeth);
- negative environmental impact, excessive intake of iodine, fluorine and chlorine in water and food;
- no medical monitoring medication intake, in particular iodine-containing and hormonal preparations;
- long exposure to sunlight or radiation exposure;
- stressful situations.
Symptoms of autoimmune thyroiditis
In most cases, thyroiditis proceed very quickly, without any symptoms. Very rarely, the patient has a slight fatigue, weakness, joint pain and discomfort in the thyroid gland - a feeling of pressure, lump in the throat.
postpartum thyroiditis usually it manifests itself a violation of production of thyroid hormones by about 14 weeks after childbirth. Symptomatology such thyroiditis manifested by fatigue, severe weakness and weight loss. Sometimes a malfunction of the thyroid gland (tireoksikoz) manifested as tachycardia, hot flashes, excessive sweating, shake the limbs, mood instability, and even insomnia. Drastic disruption of cancer usually occurs at the 19th week and may be associated with post-natal depression.
Silent (silent) thyroiditis reflected light thyroid dysfunction.
Cytokine-induced thyroiditis and almost no effect on the patient's condition and revealed only through analysis.
Diagnostics
Before the advent of disorders of the thyroid gland, identified by assays to diagnose disease is almost not possible. Only laboratory tests can establish the presence (or absence) of the disease. If other family members have any autoimmune disorders, you should be sure to carry out laboratory tests, which in this case must include:
- general blood test to detect an increased number of lymphocytes;
- immunogram for determining the presence antibodies to thyroglobulin (AT-TG), thyroid peroxidase and the thyroid to the thyroid hormone;
- definition T3 and T4 (Total and free), i.e. determining the level of TSH (Thyroid stimulating hormone) in the blood serum;
- Ultrasound of the thyroid gland, which helps to identify the increase or decrease in the size of the thyroid gland and changes in its structure;
- needle biopsy, which will help to identify an increase in lymphocytes and other cells, characteristic of autoimmune thyroiditis.
If at least one of the indicators of the disease in the results of the research is absent, the diagnosis of autoimmune thyroiditis is not possible due to the fact that the presence of TPO (Hypoechogenicity, it is suspected breast change during the US) can not serve as proof of the manifestations of the disease, when other tests do not give grounds for such a conclusion.
thyroiditis treatment
To date, no effective methods have been developed treating autoimmune thyroiditis. In case of thyrotoxic phase of the disease (appearance of blood thyroid hormones) Appointment tirostatikov, that is, drugs that suppress the activity of the thyroid gland (methimazole, carbimazole, propitsil), not recommended.
If a patient has autoimmune thyroiditis revealed violations in the cardiovascular system, are appointed by beta-blockers.
thyroid medication indicated for identifying thyroid dysfunctions - levothyroxine (L-thyroxine) and treatment necessarily combined with regular monitoring of the clinical picture of the disease and the determination of the content of thyroid-stimulating hormone in the blood serum.
Often, in the autumn-winter period in patients with autoimmune thyroiditis observed occurrence of subacute thyroiditis, ie, inflammation of the thyroid gland. In such cases, the appointed glucocorticoids (prednisolone). To combat the increasing number of antibodies in the patient's body are used such non-steroidal anti-inflammatory drugs as voltaren, indomethacin, indomethacin.
In case of a sharp increase in the size recommended thyroid surgery.
Forecast
The normal state of health and working capacity of patients can sometimes be stored for 15 years or more, despite the short-term aggravation of the disease.
Autoimmune thyroiditis and high antibody content may be considered as the factor of increased the risk of hypothyroidism in the future, that is, reducing the amount produced by a gland hormones.
In the case of postpartum thyroiditis risk of recurrence after a second pregnancy is 70%. However, about 25-30% of women in the future have a chronic autoimmune thyroiditis with the transition to stable hypothyroidism.
prevention
In identifying autoimmune thyroiditis without the expressed disorders of the thyroid gland function needs to be patient constant medical supervision for timely diagnosis and immediate treatment manifestations hypothyroidism.
