Goiter Hashimoto (Hashimoto)
Content:
- What is Hashimoto's goiter?
- Hashimoto's goiter symptoms
- Causes of Hashimoto's goiter
- Hashimoto's goiter treatment
What is Hashimoto's goiter?
Hashimoto's goiter (autoimmune thyroiditis) is an inflammation of the thyroid gland that is chronic and is caused by autoimmune disorders. The patient's immune system produces antibodies that attack the thyroid cells. Against the background of this disease, primary hypothyroidism often develops.
Hashimoto's thyroiditis usually appears after 50 years in about 1% of the population. In women, the disease is much more common than in men. The symptoms were first described by Hakaru Hashimoto (alternative transcription - Hashimoto), a Japanese surgeon, in 1912.
Clinical variants of Hashimoto's autoimmune thyroiditis:
- Hypertrophic (hyperplastic) form, in which a goiter is formed;
- Trophic form - connective tissues replace the tissues of the organ, the gland decreases in size due to the death of a large number of thyrocytes, hypothyroidism occurs (lack of hormones);
- Focal form - one lobe of the thyroid gland is affected.
Hashimoto's goiter symptoms
In the initial stages, Hashimoto's (Hashimoto's) autoimmune thyroiditis goes unnoticed, and symptoms do not appear for a long time. Patients complain of general fatigue and weakness. The main symptom is an increase or change in the shape of the thyroid gland. The patient often does not notice this. In most cases, the disease is detected by accident. With a large goiter, patients complain of pain and discomfort in the neck.
The prolonged existence of a goiter can cause compression of nearby organs - the trachea and esophagus. Other symptoms include shortness of breath, which increases in a horizontal position, memory loss, constipation, impaired sexual function, edema, deterioration of the skin, hair, their unhealthy appearance, brittle nails.
Causes of Hashimoto's goiter
Nowadays, with the modern level of development of science, it is believed that the disease appears due to congenital disorders of immunological control, which makes it possible to compare it with diffuse toxic goiter. Both diseases are often associated with other autoimmune pathologies not associated with the endocrine system. The patient's body produces antibodies that come into conflict with the components of the thyroid gland, as a result of which its autoimmune damage occurs.
Risk factors for autoimmune thyroiditis:
- Existing diffuse toxic goiter;
- Surgical interventions on the thyroid gland;
- History of autoimmune pathologies;
- Inflammatory processes, infectious diseases;
-
Relatives with autoimmune thyroiditis.
Hashimoto's goiter treatment
The initial diagnosis is determined exclusively if hypothyroidism appears, various types of compaction in the thyroid gland, or its volume increases significantly.
With this disease, laboratory tests show that the amount of antibodies in the blood is much higher than normal. Hashimoto's (Hashimoto's) autoimmune thyroiditis should not be confused with malignant neoplasms in the thyroid gland, especially if there is a dense nodular goiter. It is important to pay attention to the content of specific antibodies in the blood in order to exclude the possibility of cancer.
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A puncture biopsy will provide the necessary information when examining the thyroid gland. It is very important to assess the ability of the gland to perform its functions. They study the level of thyroid hormones, investigate the reaction to radioactive iodine, make a test with thyroliberin.
Treatment for Hashimoto's goiter is long-term and may take several years. The dose of hormones is selected for each patient individually, taking into account the age characteristics of the patient, the presence or absence of heart and vascular diseases. The amount of the drug is calculated as follows - 1.6 μg of levothyroxine for each kilogram of the patient's weight. Average daily dose: 75-100 mg.
The course of therapy is monitored by determining the amount of hormones in the blood every 2 months. It is also necessary to use glucocorticosteroid drugs. Most often, prednisone is prescribed. Start at 40 mg per day. Sometimes it is combined with immunostimulants. Surgical intervention is indicated if a malignant tumor is suspected, if the density of the goiter is high, also when the esophagus and trachea are compressed. Surgery is difficult to perform as it involves a large number of important blood vessels.
Although these interventions have been practiced for quite some time, they can lead to paralysis of the vocal cords or damage to the parathyroid gland. In addition, the operation does not completely solve the problem. No matter how successful it is, the patient will take hormonal drugs all his life. It's always best to weigh the risks. You should not choose surgery unless absolutely necessary.
The author of the article: Kuzmina Vera Valerievna | Endocrinologist, nutritionist
Education: Diploma of the Russian State Medical University named after NI Pirogov with a degree in General Medicine (2004). Residency at Moscow State University of Medicine and Dentistry, diploma in Endocrinology (2006).
