You are on page 1of 17

Hashimoto¶s Thyroiditis

Organ-specific autoimmune disease

Target tissue is the thyroid

Anterior region Of the neck

12-20g

THYROID

Follicles

Colloid

Thyrotropin-releasing hormone (TRH) Thyroid-stimulating hormone(TgAb) Antithyroglobulin (TSH)

Antithyroperoxidase (TPO Abs) Thyroglobulin Triiodothyronine T3 Thyroxine T4

Hashimoto¶s Thyroiditis
Chronic Autoimmune Thyroiditis
Combination of GOITER or ENLARGED THYROID, HYPOTHYROIDISM and THYROID AUTOANTIBODIES

Thyroid gland enlarged or rubbery

Hashimoto¶s Thyroiditis
Puffy face with edematous eyelids

qSweating

Dry skin

Symptoms
Dry and brittle hair

Pallor with a yellow tinge

o Weight

Hashimoto¶s Thyroiditis

Hashimoto¶s Thyroiditis
Genetic Predisposition
Associated with HLA antigens ( HLA-DR4 and HLA-DR5 ) HLA DR antigens are expressed on the cell surface of Thyroid Epithelial Cells during the progress of the disease

DQA1 and DQB1

Hashimoto¶s Thyroiditis
Clinical Manifestations

Low levels of T3 and T4

High TSH levels

Hashimoto¶s Thyroiditis
Immunologic Findings
Lymphocytic infiltration within the thyroid gland

QuickTimeΠand a TIFF (LZW decompressor are needed to see this picture.

QuickTimeΠand a TIFF (LZW decompressor are needed to see this picture.

Photomicrographs of (a) normal thyroid gland showing a follicle lined by cuboidal follicular epithelial cells and (b) gland in Hashimoto¶s thyroiditis showing intense lymphocyte infiltration. [From Web Path, courtesy of E. C. Klatt, University of Utah.]

Hashimoto¶s Thyroiditis
Immunologic Findings
Cellular types present : ‡T and B cells ( T cell) ‡ macrophages ‡ plasma cells

Autoantibodies are found ( AB to Thyroglobulin and to Thyroid Peroxidase)

Hashimoto¶s Thyroiditis
Immunologic Findings

Characterized by both CELLULAR AND HUMORAL response ( T cell mediated )

Destroys the Thyroid Gland

Hashimoto¶s Thyroiditis
Laboratory Testing

Anti-Thyroglobulin Antibody

Anti- Thyroid Peroxidase Antibody

Hashimoto¶s Thyroiditis
Laboratory Testing
Peroxidase Ab

‡ IIF ‡ Particle Agglutination Assay ‡ EIA ‡ Passive agglutination

Thyroglobulin Ab

‡Indirect Immunofluorescent Assay ‡Passive Agglutination ‡Enzyme Immunoassay (EIA)

Hashimoto¶s Thyroiditis
Laboratory Testing

Indirect Immunoflourescent Assay
Thyroglobulin antibodies floccular or puffy staining pattern CA2 antibodies diffuse or ground glass appearance

Hashimoto¶s Thyroiditis
Laboratory Testing

Negative result does not necessarily rule out the disease

Titer is higher

Thank You!