Hashimoto’s Thyroiditis – A predominantly Multinodular Thyroid Disorder in Coastal South India
Keywords:
Hashimoto’s thyroiditis, multinodular goiter, diffuse goiter, hypothyroidism, thyroidectomy.
Abstract
Introduction:Hashimoto’s thyroiditis is common cause of diffuse goiter and hypothyroidism in US. But in India hashimoto’s thyroiditis is increasingly presenting as nodular goiter. This is significant as multi nodular goitres in young adults and adolescents have varying causes and HT requires a different therapeutic approach and if untreated can progress to malignancies later.Objectives & aim:To estimate the proportion of Multi Nodular form of Hashimoto’s Thyroiditis among cases of thyroid disorders andTo determine the causative factors for Multi Nodular form of Hashimoto’s Thyroiditis.Materials & methods :This is a cross sectional study of patients who reported with thyroid enlargements at the General Surgery department of this hospital during a period of 3 years between January 2013 and December 2015was done. All patients who underwent thyroidectomy with histology proven Hashimoto’s thyroiditis were included in the study.Results:In our study conducted retrospectively in a 122 patients who underwent thyroidectomy surgery, the most common presenting symptom was nodular goiter(81.9%).The incidence of Hashimoto’s thyroiditis is high (36%) in the age group of 31 – 40 years, followed by 21 – 30 years of age(24.6%). The incidence of Hashimoto’s thyroiditis is more common in females with a F:M of 30.5:1. In total no of 122 patients, 36% presented in the euthyroid state.Conclusion:The increased incidence of Multinodular goiter in Indian population and euthyroid state could indicate variation in etiopathogenetic factors attributed to racial characters, dietary factors and iodine consumption.DOI:10.21276/APALM.1638References
REFERENCES
1. Larson S, Jackson L, Riall T, Uchida T, Thomas R, Qiu S et al. Increased Incidence of Well-Differentiated Thyroid Cancer Associated with Hashimoto Thyroiditis and the Role of the PI3k/Akt Pathway. Journal of the American College of Surgeons. 2007;204(5):764-773.
2. Bhargav P, Shekhar S. Surgical Indications for Goiter with Background Hashimoto’s Thyroiditis: Institutional Experience. Indian Journal of Surgery. 2011;73(6):414-418.
3. Chandanwale S, Gore C, Bamanikar S, Gupta N, Gupta K. Cytomorphologic spectrum of Hashimoto′s thyroiditis and its clinical correlation: A retrospective study of 52 patients. CytoJournal. 2014;11(1):9.
4. Pradeep P, Ragavan M, Ramakrishna B, Jayasree B, Skandha S. Surgery in Hashimoto′s thyroiditis: Indications, complications, and associated cancers. Journal of Postgraduate Medicine. 2011;57(2):120.
5. Amani H. Histopathologic and immunohistochemical features of Hashimoto thyroiditis. Indian Journal of Pathology and Microbiology. 2011;54(3):464.
6. Thomas T, Sreedharan S, Khadilkar UN, Deviprasad D, Kamath M P, Bhojwani KM, Alva A. Clinical, biochemical & cytomorphologic study on Hashimoto's thyroiditis. Indian J Med Res. 2014;140:729-35.
7. Bhatia A, Rajwanshi A, Dash R, Mittal B, saxena A. Lymphocytic Thyroiditis – is cytological grading significant? A correlation of grades with clinical, biochemical, ltrasonographic and radionuclide parameters. CytoJournal. 2007;4(1):10.
8. Repplinger D, Bargren A, Zhang Y, Adler J, Haymart M, Chen H. 118. Is Hashimoto’S Thyroiditis a Risk Factor for Papillary Thyroid Cancer?. Journal of Surgical Research. 2008;144(2):228.
9. Shih M, Lee J, Hsieh C, Yu J, Liu H, Kebebew E et al. Thyroidectomy for Hashimoto's Thyroiditis: Complications and Associated Cancers. Thyroid. 2008;18(7):729-734.
10. Zois C, Stavrou I, Kalogera C, Svarna E, Dimoliatis I, Seferiadis K et al. High Prevalence of Autoimmune Thyroiditis in Schoolchildren After Elimination of Iodine Deficiency in Northwestern Greece. Thyroid. 2003;13(5):485-489.
11. Slowinska-Klencka D, Klencki M, Sporny S, Lewinski A. Fine-needle aspiration biopsy of the thyroid in an area of endemic goitre: influence of restored sufficient iodine supplementation on the clinical significance of cytological results. European Journal of Endocrinology. 2002;146(1):19-26
12. Premawardhana L, Parkes A, Smyth P, Wijeyaratne C, Jayasinghe A, de Silva D et al. Increased prevalence of thyroglobulin antibodies in Sri Lankan schoolgirls--is iodine the cause?. European Journal of Endocrinology. 2000;143(2):185-188.
13. Siriweera E, Ratnatunga N. Profile of Hashimoto's Thyroiditis in Sri Lankans: Is There an Increased Risk of Ancillary Pathologies in Hashimoto's Thyroiditis?. Journal of Thyroid Research. 2010;2010:1-5.
14. Nguyen G, Ginsberg J, Crockford P, Villanueva R. Hashimoto's thyroiditis: Cytodiagnostic accuracy and pitfalls. Diagnostic Cytopathology. 1997;16(6):531-536.
15. Staii A, Mirocha S, Todorova-Koteva K, Glinberg S, Jaume J. Hashimoto thyroiditis is more frequent than expected when diagnosed by cytology which uncovers a pre-clinical state. Thyroid Research. 2010;3(1):11.
16. Gasbarri A, Sciacchitano S, Marasco A, Papotti M, Di Napoli A, Marzullo A et al. Detection and molecular characterisation of thyroid cancer precursor lesions in a specific subset of Hashimoto's thyroiditis. British Journal of Cancer. 2004;91(6):1096-1104.
17. McManus C, Luo J, Sippel R, Chen H. Is thyroidectomy in patients with Hashimoto thyroiditis more risky?. Journal of Surgical Research. 2012;178(2):529-532.
18. Guan H, Li C, Li Y, Fan C, Teng Y, Shan Z et al. High iodine intake is a risk factor of post-partum thyroiditis: Result of a survey from Shenyang, China. Journal of Endocrinological Investigation. 2005;28(1):876-881.
19. Iyengar K, Sthaneshwar P, Hayati J, Jayaram G. Hashimoto′s thyroiditis- A Malaysian perspective. Journal of Cytology. 2007;24(3):119.
1. Larson S, Jackson L, Riall T, Uchida T, Thomas R, Qiu S et al. Increased Incidence of Well-Differentiated Thyroid Cancer Associated with Hashimoto Thyroiditis and the Role of the PI3k/Akt Pathway. Journal of the American College of Surgeons. 2007;204(5):764-773.
2. Bhargav P, Shekhar S. Surgical Indications for Goiter with Background Hashimoto’s Thyroiditis: Institutional Experience. Indian Journal of Surgery. 2011;73(6):414-418.
3. Chandanwale S, Gore C, Bamanikar S, Gupta N, Gupta K. Cytomorphologic spectrum of Hashimoto′s thyroiditis and its clinical correlation: A retrospective study of 52 patients. CytoJournal. 2014;11(1):9.
4. Pradeep P, Ragavan M, Ramakrishna B, Jayasree B, Skandha S. Surgery in Hashimoto′s thyroiditis: Indications, complications, and associated cancers. Journal of Postgraduate Medicine. 2011;57(2):120.
5. Amani H. Histopathologic and immunohistochemical features of Hashimoto thyroiditis. Indian Journal of Pathology and Microbiology. 2011;54(3):464.
6. Thomas T, Sreedharan S, Khadilkar UN, Deviprasad D, Kamath M P, Bhojwani KM, Alva A. Clinical, biochemical & cytomorphologic study on Hashimoto's thyroiditis. Indian J Med Res. 2014;140:729-35.
7. Bhatia A, Rajwanshi A, Dash R, Mittal B, saxena A. Lymphocytic Thyroiditis – is cytological grading significant? A correlation of grades with clinical, biochemical, ltrasonographic and radionuclide parameters. CytoJournal. 2007;4(1):10.
8. Repplinger D, Bargren A, Zhang Y, Adler J, Haymart M, Chen H. 118. Is Hashimoto’S Thyroiditis a Risk Factor for Papillary Thyroid Cancer?. Journal of Surgical Research. 2008;144(2):228.
9. Shih M, Lee J, Hsieh C, Yu J, Liu H, Kebebew E et al. Thyroidectomy for Hashimoto's Thyroiditis: Complications and Associated Cancers. Thyroid. 2008;18(7):729-734.
10. Zois C, Stavrou I, Kalogera C, Svarna E, Dimoliatis I, Seferiadis K et al. High Prevalence of Autoimmune Thyroiditis in Schoolchildren After Elimination of Iodine Deficiency in Northwestern Greece. Thyroid. 2003;13(5):485-489.
11. Slowinska-Klencka D, Klencki M, Sporny S, Lewinski A. Fine-needle aspiration biopsy of the thyroid in an area of endemic goitre: influence of restored sufficient iodine supplementation on the clinical significance of cytological results. European Journal of Endocrinology. 2002;146(1):19-26
12. Premawardhana L, Parkes A, Smyth P, Wijeyaratne C, Jayasinghe A, de Silva D et al. Increased prevalence of thyroglobulin antibodies in Sri Lankan schoolgirls--is iodine the cause?. European Journal of Endocrinology. 2000;143(2):185-188.
13. Siriweera E, Ratnatunga N. Profile of Hashimoto's Thyroiditis in Sri Lankans: Is There an Increased Risk of Ancillary Pathologies in Hashimoto's Thyroiditis?. Journal of Thyroid Research. 2010;2010:1-5.
14. Nguyen G, Ginsberg J, Crockford P, Villanueva R. Hashimoto's thyroiditis: Cytodiagnostic accuracy and pitfalls. Diagnostic Cytopathology. 1997;16(6):531-536.
15. Staii A, Mirocha S, Todorova-Koteva K, Glinberg S, Jaume J. Hashimoto thyroiditis is more frequent than expected when diagnosed by cytology which uncovers a pre-clinical state. Thyroid Research. 2010;3(1):11.
16. Gasbarri A, Sciacchitano S, Marasco A, Papotti M, Di Napoli A, Marzullo A et al. Detection and molecular characterisation of thyroid cancer precursor lesions in a specific subset of Hashimoto's thyroiditis. British Journal of Cancer. 2004;91(6):1096-1104.
17. McManus C, Luo J, Sippel R, Chen H. Is thyroidectomy in patients with Hashimoto thyroiditis more risky?. Journal of Surgical Research. 2012;178(2):529-532.
18. Guan H, Li C, Li Y, Fan C, Teng Y, Shan Z et al. High iodine intake is a risk factor of post-partum thyroiditis: Result of a survey from Shenyang, China. Journal of Endocrinological Investigation. 2005;28(1):876-881.
19. Iyengar K, Sthaneshwar P, Hayati J, Jayaram G. Hashimoto′s thyroiditis- A Malaysian perspective. Journal of Cytology. 2007;24(3):119.
Published
2018-03-22
Issue
Section
Original Article
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access at http://opcit.eprints.org/oacitation-biblio.html).
