HYPOTHYROIDISM-CHRONIC AUTOIMMUNE THYROIDITIS

SUMMARY

1. AKA Hashimoto thyroiditis; most common cause of hypothyroidism; women > men; positive family history.

2. assoc. with type 1 DM, primary adrenal insufficiency, pernicious anaemia, vertiligo.

3. Painless, chornic, lymphocytic infiltration of the gland ⟹ firm + irregular goiter.

4. Immune-mediated thyroid cell apoptosis.

5. Inx: 95% of patients have anti-TPO antibodies; progressive rise in TSH; progressive fall in free T4. Variant is hyperthyroidism followed by hypothyroidism.

6. DDx: painless thyroiditis, postpartum thyroiditis.

7. Tx: levothyroxine.

Reference(s)

Wilkinson, I., Furmedge, D. and Sinharay, R. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press. Get it on Amazon.
Feather, A., Randall, D. and Waterhouse, M. (2020). Kumar And Clark’s Clinical Medicine. 10th ed. S.L.: Elsevier Health Sciences. Get it on Amazon.
Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
Therapeutic Guidelines. Melbourne: Therapeutic Guidelines Limited. https://www.tg.org.au [Accessed 2021].