Hashimoto’s Disease – Hypothyroidism

by Carlo Raj, MD

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    Let’s talk about Hashimoto’s in great detail. Most common of the hypothyroidism in the world, early in the course presents how? Once again, Hashitoxicosis, we have had the discussion plenty. Characterized by gradual thyroid failure, initially there might be release of T3, T4, eventually leading into permanent, permanent, permanent primary hypothyroidism, most prevalent in elderly females, autoimmune, 20:1 ratio of women to men and you want to memorize by all means HLA-DR5 and B5. Pathogenesis, what happens? You have anti thyroglobulin antibodies, you might have antibodies that are attacking thyroid peroxidase TSH receptors. Do you see anywhere along the line of thyroid hormone synthesis, you might have autoantibodies that are then-that are then attacking it resulting in primary hypothyroidism. If I were you, I would pay attention to the first two bullet points. Autoimmune disease, it is going to be diffused enlarged on the thyroid. Notice, I did not say diffused radioactive iodine uptake, huh! Firm, non-tender goiter, hypothyroidism preceded by transient thyrotoxicosis, one more time, due to the release of your thyroid hormones from your colloid. Eventually, gland becomes shrunken and dead, it is with lymphocytic infiltration. In fact, if you were to take a look at the picture here, histologically, you will notice a swarm of “bees” referring to lymphocytes coming in there and completely annihilating or just about completely annihilating this thyroid gland. It is very difficult for us to clearly identify a normal thyroid follicular cell. You don’t find the normal colloid that you would expect to see and at this point, I fully expect you to know what a normal thyroid follicular cell looks like with that central region of colloid. And with all this lymphocytic infiltration, no wonder your thyroid gland is going to be destroyed complete. Cytology upon FNA, what is variable, but...

    About the Lecture

    The lecture Hashimoto’s Disease – Hypothyroidism by Carlo Raj, MD is from the course Thyroid Gland Disorders.

    Included Quiz Questions

    1. HLA-DR5 and HLA-B5
    2. HLA-DR2 and HLA-B47
    3. HLA-DR5 and HLA-B27
    4. HLA-DQ2 and HLA-DR3
    5. HLA-DR4 and HLA-B5
    1. Peripheral deiodinase
    2. Thyroglobulin
    3. Thyroid peroxidase
    4. TSH receptor
    5. Iodine receptor
    1. Eosinophilia
    2. Destruction of follicle
    3. Lymphocytic infiltration
    4. Hürthle cells
    5. Normal surgical findings

    Author of lecture Hashimoto’s Disease – Hypothyroidism

     Carlo Raj, MD

    Carlo Raj, MD

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