Test Paper 6
Teck Yew Chin, Susan Cheng Shelmerdine, Akash Ganguly, Chinedum Anosike in Get Through, 2017
Hashimoto thyroiditis, also known as chronic autoimmune lymphocytic thyroiditis, is a disease with a typical clinical presentation of painless diffuse enlargement of the thyroid gland accompanied by hypothyroidism and thyroid autoantibodies. The sonographic appearance of Hashimoto thyroiditis is well recognised. The gland is often diffusely enlarged, and the parenchyma is coarsened, hypoechoic and often hypervascular. A micronodular pattern on ultrasound is highly diagnostic of Hashimoto thyroiditis with a positive predictive value of 95%. Discrete nodules may, however, also occur within diffusely altered parenchyma or within sonographically normal parenchyma. The nodular form of Hashimoto thyroiditis has not received nearly as much analysis as the diffuse form, and the reported findings have been variable.
Data and Picture Interpretation Stations Cases 1–42
Joseph Manjaly, Peter Kullar, Alison Carter, Richard Fox in ENT OSCEs: A Guide to Passing the DO-HNS and MRCS (ENT) OSCE, 2019
What is the diagnosis? Hashimoto thyroiditis
Shifting cervical lymphadenopathy in Hashimoto’s disease
Published in Baylor University Medical Center Proceedings, 2019
Dillon Medlock, Ellen Chaljub, Meredith Gavin, Alan N. Peiris
Hashimoto thyroiditis is most commonly associated with hypothyroidism. The presence of antibodies to thyroid antigens is found in most patients.1 Ultrasound of the neck can be normal or show thyroid heterogeneity and/or nodules. Although sometimes overlooked, cervical lymphadenopathy on ultrasound may support a diagnosis of Hashimoto thyroiditis.2 This lymphadenopathy is typically found in neck levels II–IV and VI.3 Paratracheal lymph nodes may be involved in Hashimoto’s thyroiditis.4 The lymphadenopathy locations reported correlate well with the lymphatic drainage of the thyroid gland, suggesting that lymphatic drainage is likely involved in the pathogenesis of lymphadenopathy in Hashimoto’s disease. Specifically, nodes in neck levels III, IV, V, and VI collect lymph from the thyroid gland.5
Transient T3 toxicosis associated with Hashimoto’s disease
Published in Baylor University Medical Center Proceedings, 2019
Sarah Jaroudi, Meredith Gavin, Kathryn Boylan, Alan N. Peiris
Hashimoto thyroiditis is most commonly associated with hypothyroidism.1 Antibodies to thyroid antigens (usually thyroperoxidase and thyroglobulin) are found in a majority of patients.2 Rarely, thyrotoxicosis can result from Hashimoto’s disease. This can be seen early in the course of the disease and manifests with an elevated free T4 and a suppressed thyroid-stimulating hormone (TSH) level (Hashitoxicosis). This hyperthyroid phase usually results from increased synthesis and release of thyroid hormone. Hashitoxicosis is seen in about 5% of cases of Hashimoto’s thyroiditis.1 Although it usually subsides over time, a small proportion of patients will have waxing and waning of thyroid hormone levels. Some with Hashitoxicosis may need antithyroid treatment pending such resolution.
Does subclinical hypothyroidism and/or thyroid autoimmunity influence the IVF/ICSI outcome? Review of the literature
Published in Gynecological Endocrinology, 2019
Galina Khachikovna Safarian, Alexander Mkrtichevich Gzgzyan, Kharryasovna Dzhemlikhanova Lyailya, Dariko Alexandrovna Niauri
Autoimmune thyroiditis (Hashimoto’s thyroiditis, HT) – chronic progressive disease characterized by lymphoid infiltration of the thyroid gland including T and B cells, resulting in inflammation and leading to the gradual extinction of thyroid function with a number of complications. Therefore, both cellular and humoral immunity have a role in the pathogenesis of thyroid autoimmunity. In Russia, the frequency of AIT reaches 45 cases per 1000 population, in the USA since 1997, AIT ranks third in terms of the prevalence of autoimmune diseases. Hashimoto thyroiditis is the most frequent autoimmune condition among reproductive-aged women. The condition is characterized as the presence of serum antibodies directed against a membrane-associated hemoglycoprotein expressed only in thyrocytes (thyroperoxidase, TPO-abs) or a glycoprotein homodimer produced predominantly by the thyroid gland (thyroglobulin, Tg-abs) [3]. It was demonstrated that in women presenting with thyroid autoimmunity, the prevalence of infertility was as high as up to 47% [4]. According to the recommendation of the American Society for Reproductive Medicine, the level of TSH before entering the IVF program should not exceed 2.5 mIU/L [5]. The prevalence of TPO-abs is 8–14% in women of reproductive age, while the incidence of subclinical hypothyroidism (SCH) in the same population is approximately 4–8% [5,6].
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