Thyroid disease is defined as a condition of malfunction of thyroid.
Hyperthyroidism is a condition in which the thyroid gland is over active
and produces too much thyroid hormones. Hypothyroidism is a condition
in which the thyroid gland is under active and produces very little
thyroid hormones. Thyroid cancer is defined as condition in which the
cells in the thyroid gland have become cancerous.
Hashimoto’s thyroiditis (chronic lymphocytic thyroiditis)
Hashimoto’s thyroiditis is an autoimmune disease in which the immune
system attacks the thyroid gland of that mostly often leads an
underactive thyroid gland (hypothyroidism). According to the study by
the University of Pisa, Women with Hashimoto’s thyroiditis (HT) suffer
from a high symptom load independently from hypothyroidism, which
results just a contributing factor to the development of the clinical
syndrome. In agreement with these results, we recently reported on the
presence of symptoms and signs consistent with fibromyalgia (FM) in
patients with HT regardless thyroid dysfunction, focusing to the weight
of anti-thyroid autoimmunity in the HT-associated clinical syndrome(a).
B.1 Causes
1. Autoimmune disorder
In the study to summarize the current knowledge on Hashimoto’s
thyroiditis and its pathogenesis and to introduce the readers to the
basic concept of autoimmune thyroid disease, found that Hashimoto’s
thyroiditis and Graves’ disease are different expressions of a basically
similar autoimmune process, and the clinical appearance reflects the
spectrum of the immune response in a particular patient. During this
response, cytotoxic autoantibodies, stimulatory autoantibodies, blocking
autoantibodies, or cell-mediated autoimmunity may be observed. Persons
with classic Hashimoto’s thyroiditis have serum antibodies reacting with
thyroglobulin and thyroid peroxidase. These antibodies (particularly
antibodies against thyroid peroxidase) are complement-fixing
immunoglobulins and may be cytotoxic. In addition, many patients have
cell-mediated immunity directed against thyroid antigens. Cell
mediated-immunity is also a feature of experimental thyroiditis induced
in animals by injection of thyroid antigen with adjuvants. Hashimoto’s
thyroiditis is predominantly the clinical expression of cell-mediated
immunity leading to destruction of thyroid cells, which in its severest
form causes thyroid failure(3a).
1. Primary hyperparathyroidism (PHPT)
In the study to investigate and determine the prevalence of patients
having both HT and PHPT, and the possible relation between these two
diseases including 45,231 patients, which were referred by their general
practitioner or endocrinologist, under suspicion of having thyroid
and/or parathyroid disease., indicated that all 2,267 patients had
normal or slightly elevated TSH levels. In conclusion, although the
reported rate of prevalence of PHPT in the general population is about
0.3%, our results indicated a 1.89% occurrence of PHPT in 2267 patients
with HT in central Serbia. This may be due to the autoimmune
inflammatory process in HT supporting PHPT to PTH or calcium supporting
HT or to common genetical predisposition of both entities(3).
2. Cerebellar ataxia
Both hypothyroidism and Hashimoto’s thyroiditis (HT) can rarely be associated with cerebellar ataxia.
There is a report of a report a 74-year-old male with hypothyroidism
and a 20-year history of ET who developed cerebellar ataxia after
bilateral thalamic DBS. Extensive workup revealed elevated thyroid
stimulating hormone and thyroperoxidase antibody titers confirming the
diagnosis of HT(4).
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Sources
(a) http://www.ncbi.nlm.nih.gov/pubmed/22147633
(3a) http://www.ncbi.nlm.nih.gov/pubmed/19667753
(3) http://www.ncbi.nlm.nih.gov/pubmed/23865082
(4) http://www.ncbi.nlm.nih.gov/pubmed/23439792
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