This Video tutorial will help you in understanding the etiopathogenesis, morphology and complications of Hashimoto’s Thyroiditis
Most common cause of hypothyroidism in areas where iodine levels are sufficient.
Gradual thyroid failure due to autoimmune destruction of thyroid gland
Definition:It is Characterized by
1. Diffuse goitrous enlargement of the thyroid
2. Lymphocytic infiltration of the thyroid gland
3. Presence of thyroid autoantibodies.
Age incidence: 45 – 65yrs. Male: Female: 1:10 to 1:20
It can occur in children and is a major cause of nonendemic goiter in children.
1. Genetic predisposition.
2. Immune causes: Autoantibody production
3. Environmental factors: In a genetically susceptible individual environmental factors, such as infection, dietary factors (iodine), stress and pregnancy, may initiate autoimmunity in the thyroid.
Genetic predisposition:HLA-DR3 & DR5
Immune Regulatory Genes
[CTLA4, PTPN22] cytotoxic T lymphocyte–associated antigen-4 (CTLA4)
protein tyrosine phosphatase-22
Thyroid specific genes
(thyroglobulin and thyroid-stimulating hormone [TSH] receptor )
-Diffuse enlargement , may be Nodular
– Gland well demarcated Cut section; Pale, yellow tan, rubbery to firm/nodular
Atrophy of the follicles
Diffuse infiltration by mononuclear cells
Formation of lymphoid follicles
Hurthle cell metaplasia
Interstitial connective tissue may be increased
Clinical features : Middle aged women
Variable degree of
Laboratory findings: T3 & T4 decreased
Diagnostic tests: FNAC
HPE of Biopsy
B-cell Non Hodgkin Lymphoma
Increased risk for other autoimmune diseases
Diabetes type 1, Adrenalitis, SLE, Myasthenia Gravis..
Increased risk(variable) thyroid epithelial neoplasms.. Papillary Carcinoma