Hashimoto goiter (autoimmune thyroiditis) is an inflammation of the thyroid gland that occurs chronically and is caused by autoimmune disorders. The patient’s immune system produces antibodies that attack the thyroid cells. Against the background of this disease, primary hypothyroidism often develops.
Hashimoto's thyroiditis usually occurs after 50 years in about 1% of the population. In women, the disease is much more common than in men. Symptoms were first described by Hakaru Hashimoto (an alternative transcription - Hashimoto), a Japanese surgeon, in 1912.
Clinical options for Hashimoto autoimmune thyroiditis:
Hypertrophic (hyperplastic) form in which goiter is formed,
Trophic form - connective tissues replace organ tissue, iron decreases in size due to the death of a large number of thyrocytes, hypothyroidism occurs (lack of hormones),
Focal form - one lobe of the thyroid gland is affected.
Goiter symptoms Hashimoto
In the initial stages, autoimmune thyroiditis Hashimoto (Hashimoto) proceeds imperceptibly, and the symptoms do not appear for a long time. Patients complain of general fatigue and weakness. The main symptom is an increase or change in the shape of the thyroid gland. The patient often does not notice. In most cases, the disease is detected by chance. For large goiter patients complain of pain and discomfort in the neck.
The long existence of goiter can cause compression of nearby organs - the trachea and esophagus. Other symptoms include shortness of breath, which increases in a horizontal position, loss of memory, constipation, impaired sexual function, swelling, deterioration of the skin, hair, their unhealthy appearance, brittle nails.
Causes of goiter Hashimoto
Nowadays, at the present level of development of science, it is believed that the disease appears due to congenital disorders of immunological control, which allows comparing it with diffuse toxic goiter. Both diseases are often combined with other autoimmune pathologies that are not associated with the endocrine system. In the patient's body, antibodies are produced that conflict with the components of the thyroid gland, resulting in its autoimmune damage.
Risk factors for autoimmune thyroiditis:
Existing diffuse toxic goiter,
Surgical interventions on the thyroid gland,
Autoimmune pathologies in history
Inflammatory processes, infectious diseases,
Relatives with autoimmune thyroiditis.
Treatment of goiter Hashimoto
The primary diagnosis is determined solely if there is hypothyroidism, various kinds of seals in the thyroid gland, or its volume increases significantly.
In this disease, laboratory tests show that the amount of antibodies in the blood is significantly higher than normal. Do not confuse autoimmune thyroiditis Hashimoto (Hashimoto) with malignant tumors in the thyroid gland, especially if there is a dense nodular goiter. It is important to pay attention to the content of specific antibodies in the blood in order to exclude the possibility of cancer.
Puncture biopsy will provide the necessary information when studying the thyroid gland. It is very important to assess the ability of the gland to perform its functions. They study the level of thyroid hormones, investigate the reaction to radioactive iodine, make a test with thyroliberin.
Hashimoto goiter treatment is long, it can take several years. The dose of hormones is selected for each patient individually, taking into account the age characteristics of the patient, the presence or absence of diseases of the heart and blood vessels. The amount of the drug is calculated as follows: 1.6 mcg of levothyroxine per kilogram of the patient's weight. Average daily dose: 75-100 mg.
The course of therapy is monitored by determining the amount of hormones in the blood every 2 months. It is also necessary to use glucocorticosteroid drugs. Most often, prednisone is prescribed. Start with 40 mg per day. Sometimes it is combined with immunostimulants. Surgical intervention is indicated when a malignant tumor is suspected, if the density of the goiter is large, also in case of compression of the esophagus and trachea. Surgery is difficult to perform, as it affects a large number of important blood vessels.
Although such interventions have been practiced for quite some time, they can lead to paralysis of the vocal cords or damage to the parathyroid gland. In addition, the operation does not solve the problem completely. No matter how successful she is, the patient will take hormone preparations throughout her life. It is always better to weigh all the risks. You should not choose surgery without extreme necessity.
Education: Diploma RSMU them. N. I. Pirogov, specialty "General Medicine" (2004). Residency at the Moscow State University of Medicine and Dentistry, diploma in "Endocrinology" (2006).
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Text of scientific work on the topic "Autoimmune thyroiditis (goiter Hashimoto)"
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Bilateral renal agenesis. This defect belongs to the third clinical type. Newborns with such a vice are mostly born dead. However, there were cases when a child was born alive and full-term, but died in the first days of his life due to renal failure.
To date, progress does not stand still, and there is a technical possibility of transplanting a newborn kidney and hemodialysis. It is very important to differentiate bilateral bilateral agenesis of the kidneys from other defects of the urinary tract and kidneys.
Unilateral agenesis of the kidneys. Unilateral agenesis of the kidney with preservation of the ureter This defect belongs to the first clinical type and is congenital. With one-sided aplasia, the only kidney, which in turn is often hyperplastic, takes over the entire load. An increase in the number of structural elements allows the kidney to take over the functions of two normal kidneys. The risk of serious consequences in case of injury of one kidney increases.
Unilateral agenesis of the kidney by the absence of the ureter. This defect manifests itself in the earliest stages of the embryonic development of the urinary system. A sign of this disease is the absence of the ureteral orifice. Due to the peculiarities of the structure of the male body, the genesis of the kidneys in men is combined with the absence of a duct that removes seminal fluid and changes in the seminal vesicles. This leads to: pain in the groin area, the sacrum, painful ejaculation, and sometimes a violation of sexual function.
When agenesis is recommended to avoid heavy physical exertion, injury! References:
1. Markosyan A.A. Questions of age physiology. - M .: Enlightenment, 1974
2. Sapin M.R. - ANATOMY AND PHYSIOLOGY OF A PERSON WITH AGE FEATURES OF A CHILDBODY. - Publishing Center "Academy" 2005
3. N. V. Krylova, T. M. Sobolev, Genitourinary Apparatus, anatomy in diagrams and drawings, publishing house of the Russian University of Peoples' Friendship, Moscow, 1994.
4. A. G. Khripkov, V. S. Mironov, I. N. Shepilo "Human Physiology", publishing house "Enlightenment", Moscow, 1971.
5. R. D. Sinelnikov "Atlas of human anatomy", publishing house "Medicine", Moscow, 1973.
6. A.V. Kraev “Human Anatomy”, Medicina Publishing House, Moscow, 1978.
7. “Operational urology” edited by N. A. Lopatkin, I. P. Shevtsova, Leningrad “Medicine”, Leningrad branch, 1986
8. Papayan A.V., Anichkova I.V. "Bladder-ureteral reflux and reflux - nephropathy" Manual for doctors "Clinical nephrology of childhood." SPb .: Sothis, 1997
9. Kenzhebaeva K.A. and others. Materials of the scientific-practical conference "Actual issues of pediatric nephrology and urology" (October 13-14, 1998), Almaty.
Bachelor, 1 course, Faculty of Civil Engineering SPSUACE, St. Petersburg, Russian Federation,
E-mail: [email protected] I. S. Moskalenko
Ph.D., associate professor, associate professor physical Sun SPSUAC, St. Petersburg, Russian Federation,
AUTOIMMUNE TYREOIDITAL (Goiter Hashimoto)
Autoimmune thyroiditis (AIT) is one of the common thyroid diseases.
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glands, since the description of which the Japanese surgeon Hashimoto has been more than 80 years.
Keywords Autoimmune thyroiditis (AIT), diagnosis, treatment.
Currently, AIT is understood to mean a chronic organ-specific disease of the thyroid gland, characterized by lymphoid infiltration of its tissue, resulting from autoimmune factors.
AIT meets the five classical criteria for autoimmune disease, formulated by F. Milgton and E. Vitebsky. These include:
¡. The presence in the patient's blood of organ-specific autoantibodies, or confirmation of cell-mediated cytotoxicity.
2. Identification of a specific autoantigen causing an immunopathological reaction.
Z. Experimental confirmation of immunoagression to this antigen, that is, the creation of an experimental model of this disease or syndrome.
4. The presence of clinical and laboratory symptoms specific for the given disease (syndrome) and pathological changes in the corresponding organs and tissues.
5. The possibility of "transplantation" of the disease to the donor as a result of the introduction of serum with antibodies or stimulated lymphocytes.
There are several options for the classification of AIT, which are based on various signs.
Disease Course of Manifestation
Hashimoto thyroiditis (hypertrophic thyroiditis) Chronic Goiter, lymphoid infiltration, follicular cell hyperplasia
Atrophic thyroiditis (primary myxedema) Chronic Atrophy of the thyroid gland, fibrosis
Juvenile thyroiditis Chronic Usually lymphoid infiltration
Postpartum thyroiditis Transient, may be progressive chronic thyroiditis Small goiter, lymphoid infiltration
Hidden thyroiditis Transient Small goiter, lymphoid infiltration
Focal thyroiditis In some patients, progressive Find a 20% autopsy
T. F. Davies and N. Amino offer a classification of autoimmune diseases of the thyroid gland, depending on the functional state and its size.
Status: euthyroidism, antibodies to TG and TPO are determined.
2A. With goiter (Hashimoto disease)
2b. Without goiter (atrophic thyroiditis)
Status: permanent persistent hypothyroidism. Antibodies to TG and TPO are determined, in the case of 2B - TSH - blocking antibodies.
2B. Transient thyroiditis
Status: begins as a transient thyrotoxicosis (elevated thyroid hormone levels with low uptake of radioactive iodine), often there is a transition to hypothyroidism, which can be
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transient. Transient hypothyroidism can occur without prior thyrotoxicosis. Antibodies to TG and TPO are determined.
Graves Disease (Type 3)
BEHIND. Hyperthyroid Graves Disease
ZB Euthyroid graves disease
ZV. Hypothyroid disease Graves.
Features of the clinical course of AIT in children
The course of AIT in childhood and adolescence has a number of features. The disease is characterized by a gradual onset, slow progression, an enlargement of the thyroid gland can be moderate and occur in a child by chance. Children, as a rule, do not make complaints. Symptoms of compression of surrounding organs and tissues with AIT in children are rare, with large goiter.
In most cases, AIT in children iron palpation differs little from the DND, its surface is smooth, the contours are clear. Classical palpatory signs of AIT (uneven, lumpy surface of the gland, the consistency of the heterogeneity) in childhood are rare. Therefore, the decisive importance in the diagnosis of AIT in children belongs to additional laboratory - instrumental methods.
The vast majority of children and adolescents with the initial stage of AIT have no clinical signs of dysfunction of the thyroid gland and the euthyroid state remains. However, in every fifth case, subclinical hypothyroidism is diagnosed. Children with AIT in the phase of subclinical and overt hypothyroidism, as well as patients with other forms of DND, often lag behind in physical, sexual and intellectual development, and also 1.5–2 times more often than their peers have various chronic somatic diseases. Girls of pubertal age, patients with AIT, in 30% of cases have various disorders of puberty: either lag in sexual development and menarche delay, or violation of the ovarian-menstrual cycle of the hypomenstrual syndrome, secondary amenorrhea.
There are already about 50 laboratory and instrumental tools and methods for diagnosing thyropathy, which can be divided into five main groups:
¡. Determination of the level of thyroid and other hormones and their carriers, which reflects the functional state of the thyroid gland (TK, T4, TSH, TSH).
2. Functional and pharmacodynamic tests and tests that clarify the state of the thyroid function and its regulatory mechanisms (RFP absorption test, samples by perchlorate, samples for a defect of seizure and defect of iodine organization).
3. Tests and methods reflecting the metabolic and regulatory effects of thyroid hormones (basal metabolic rate, time of “reflex with Achilles tendon”, cholesterol, fibronectin, cAMP concentrations).
4. Immunochemical and other methods that determine the presence of an antithyroid autoimmune reaction (autoantibodies, circulating immune complexes, sensitized lymphocytes, laboratory signs of nonspecific immunity).
5. Methods for assessing the anatomical and histological characteristics of the thyroid gland (numerous imaging and cytobiopsy methods).
Specific treatment of autoimmune thyroiditis has not been developed.
Treatment with thyroid drugs
In the presence of hypothyroidism, thyroid hormone drugs are prescribed (thyroxin, triiodothyronine, thyroidin, L-thyroxin). The daily dose of thyroxine in adults is 1.4-1.7 μg per 1 kg of body weight (about 100-175 μg per person per day), and in children - up to 4 μg per 1 kg of body weight. In some cases, in particular, with the atrophic form of autoimmune thyroiditis, an increased dose of thyroxine can be prescribed - 200-225 mg / day. Purpose of thyroid drugs, especially in individuals
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old age, you need to start with small doses (25 micrograms), increasing every 2.5–3 weeks by 25 micrograms, controlling the clinical symptoms and serum TSH levels. Given the chronic nature of the disease, treatment with thyroid drugs is carried out for a long time. Monitoring the level of TSH in serum should be carried out no more often than in 1.5-2 months. after starting treatment.
Glucocorticoid drugs are usually prescribed only when autoimmune thyroiditis is combined with subacute thyroiditis. Prednisone is usually used in a daily dose of 40 mg with a subsequent decrease.
Surgical treatment is indicated only for fast-growing goiter, compression of the trachea or neck vessels due to an enlarged thyroid gland, as well as suspected cancer in the presence of nodes.References:
1.D. S. Rafibekov, A. P. Kalinin "Autoimmune thyroiditis" - Bishkek 1996.
2.N. A. Kurmacheva “AIT in children: clinical course features”, Russian Medical Journal, 2000 - №1.
3.N.A. Petunin "Clinic, diagnosis and treatment of AIT - Problems of endocrinology", 2002 - №6.
4.T. A. Okeanova, M.E. Bronstein, EI Bazarov “Clinical“ masks ”of Hashimoto's goiter - Problems of endocrinology”, 1990.
5.I. I. Dedov, G. A. Melnichenko, V. V. Fadeev “Endocrinology”, Moscow, “Medicine” 2000. 6.E. P. Kasatkina “AIT: diagnosis and treatment - Problems of endocrinology” 2002.
Lecturer, Department of Therapy, International High School of Medicine, Bishkek, Kyrgyz Republic T.Ch. Chubakov Dr. med. sciences, professor Kyrgyz state medical institute of retraining and advanced training G. Bishkek, Kyrgyz Republic
FACTORS AFFECTING THE TERMS OF ESTABLISHMENT OF DIAGNOSIS OF LUNG TUBERCULOSIS
This article assesses the timing of a timely diagnosis and treatment of respiratory tuberculosis, including the timing of the patient’s initial referral to the doctor for the onset of symptoms and the diagnosis of tuberculosis, as well as factors affecting the timely detection and treatment.
Tuberculosis of the respiratory system, delayed diagnosis and initiation of treatment.
According to WHO (2015), tuberculosis (TB) is prevalent in all regions of the world and is still among the infectious diseases that claim the greatest number of lives. Mortality rates from this disease continue to remain at an unacceptably high level. Estimated TB Cases
Causes of development
Hashimoto goiter is an autoimmune disease. Normally, our immune system produces antibodies that protect the body against viruses, bacteria, and other foreign bodies. However, sometimes the immune system begins to direct antibodies against its own tissues and / or organs. This phenomenon is called an autoimmune disease. Specifically, with Hashimoto goiter, antibodies attack the thyroid gland. The causes of the development of this disease have not yet been established.
The doctor will conduct an examination and ask questions about the symptoms and previous diseases. He will also schedule a blood test, which will assess the quality of the thyroid gland by determining the level of specific hormones.
In addition, the physician may prescribe a number of imaging procedures, including ultrasound examination or computed tomography. They will provide an image of the thyroid gland and visually assess the presence of violations. At the same time, it is worth noting that such procedures are rarely used to diagnose Hashimoto's goiter.
Is it possible to prevent development?
There are no effective ways to prevent goiter Hashimoto.
There is no cure for Hashimoto's goiter, but this disease can be effectively controlled by medication, minimizing any long-term effects. Goitre Hashimoto is treated by taking synthetic thyroid hormone, which replaces the deficiency of naturally produced. The drug is taken daily in pill form. It regulates the hormonal level and normalizes metabolism. In addition, it allows you to reduce the level of low-density lipoproteins, thereby preventing weight gain. The duration of the drug depends on the results of the blood test. For most people, taking synthetic thyroid hormone is not accompanied by any problems or complications.
and prevents the onset of symptoms. To monitor the thyroid gland requires regular blood testing. Certain drugs, supplements, and products may impair the body's ability to perceive synthetic thyroid hormone. Be sure to tell your doctor about:
- The use of large quantities of soy products.
- Fiber-rich diet.
- Acceptance of other drugs. These may include preparations of iron and calcium, cholestyramine or aluminum hydroxide (contained in a number of anti-viruses).
Life with disease
As a rule, Hashimoto's goiter has remained stable for many years. If this does not progress to hypothyroidism, it can be easily and effectively treated.
If you have decided to become pregnant against the background of Hashimoto's goiter, please consult your doctor first. Without proper treatment, hypothyroidism can harm you and your baby. That is why throughout the entire period of pregnancy it is necessary to closely monitor the slightest symptoms of this disease. Usually drugs prescribed for diseases of the thyroid gland are safe for the fetus.
Goiter Hashimoto cure completely alone folk remedies is not possible. Various methods of alternative medicine are used only as an auxiliary therapy for stopping the symptomatic picture of the disease and enhancing the effect of drugs.
Common folk techniques to help reduce goiter:
- wearing a pendant necklace with amber-nugget
- reception decoction based on elecample.
To prepare the drug inflorescences elecampane should be collected in the second half of July. Put a handful of flowers in a 0.5 liter jar so that it is half full. Fill the tank with vodka. Leave in a dark place to infuse for 14 days.
After infusion, use the resulting tincture for gargling every evening before going to bed. Course duration is individual. You can use this recipe during the entire hormone therapy. All questions regarding the use of folk techniques need to find out from your doctor.
Diet for goiter Hashimoto
During the treatment of chronic inflammation of the thyroid gland, the diet is necessarily adjusted. Food and dishes that may affect the rate of development and spread of inflammation and the autoimmune reaction of the body are excluded from the daily menu.
Allowed to use in limited quantities:
- nuts, legumes,
- coffee, cocoa,
- spices, spices,
- pickles, smoked meat and pickles,
- citrus fruit
People diagnosed with goiter Hashimoto are forbidden to use the following products:
- kelp (including Japanese food - rolls, sushi),
- foods with a high iodine content,
- salt iodized
- fatty meats and fish.
The basis of the daily diet should be: cereals with a high content of carbohydrates, lean fish, lean meats (chicken, beef). To cure goiter faster, it is important to adjust not only the diet, but also the mode of eating. Overeating is excluded, it is necessary to take food fractional, 4-6 times a day in small portions.
Special methods of prevention of chronic autoimmune inflammation of the thyroid gland does not exist. It is almost impossible to prevent the disease, you can only reduce the likelihood of its occurrence by following simple recommendations regarding a healthy lifestyle, proper nutrition, and rejection of bad habits.
In order not to bring to the need for surgery, it is important to diagnose the disease in time. This can be done only by passing a regular routine inspection at least once a year. People who have a genetic predisposition need to undergo an ultrasound scan of the thyroid gland 2 times a year.
If you diagnose goiter at an early stage, you can stop the development of inflammation through a corrective diet.
The disease is an inflammation of the thyroid gland with a chronic course. Most often they suffer from people with various autoimmune disorders. In this case, the immune system does not recognize its thyroid cells as related and begins to fight them as if they were alien. As a result of this struggle, destructive antibodies are produced, which cause inflammation and even death of the gland, if the saving treatment does not have time in time.
According to statistics, Hashimoto Goiter is more common in men than women, and usually occurs in middle age. In rare cases, the disease is found in people of younger age, who are just over 30. This disease is also called lymphomatosis (lymphocytic) goiter or Hashimoto's disease. This pathology was discovered in 1912 by a doctor Hashimoto from Japan, and therefore bears his name. He first described in detail the symptoms of the disease. But it was not until 1956 that the scientists Denich and Root established a connection between the disease and immune disorders in the body.
The course of Hashimoto disease has 3 main forms
- Hyperplastic or hypertrophic. This form is characterized by an enlargement of the thyroid gland and the formation of a goiter of very large size, which simply begins to choke a person.
- Atrophic. In this form, the gland cells are gradually replaced by connective tissue, this process is called sclerotherapy. As thyrocytes (gland cells) die off, thyroid size decreases, and symptoms of hypothyroidism appear. Thyroid hormones are getting smaller. If time is not prescribed treatment with hormone replacement drugs, the human body is quickly depleted, and the terminal stage of the disease begins.
- Focal. In this form, only one of the thyroid lobes is affected.
Usually, Hashimoto Goiter develops very slowly, and in the initial stage it is difficult to diagnose, since the main symptoms in patients are absent. Increased fatigue, weakness and fatigue can be associated with age or associated chronic diseases. Therefore, treatment is often limited to the suppression of the manifestations of any infections. A small enlargement of the thyroid gland often goes unnoticed, and the Goiter Hashimoto in the early stages is found by chance, as a result of any medical examination. If the size of the goiter begins to increase significantly, then nearby organs and tissues begin to experience strong pressure. The trachea and esophagus are particularly affected. Such patients complain of shortness of breath, severe choking, difficulty swallowing food, discomfort in the cervical region. But they themselves write off these symptoms for heart or lung ailments.
Medical scientists explain the development of Hashimoto thyroiditis with congenital failures of the immune system. This suggests that diffuse toxic goiter and Hashimoto disease have a common mechanism of development. Often these pathologies are combined with other painful manifestations that are not related to the endocrine system. These comorbidities, such as various kinds of colitis, arthritis, and vitiligo, are also caused by an impaired immunity.
Hashimoto disease may develop as a result of the following factors.
- The manifestation and treatment of diffuse toxic goiter in history
- Surgical interventions on the thyroid gland,
- Any immune pathologies,
- Various infections.
Diagnosis of Hashimoto thyroiditis includes an external examination of the patient, his complaints about the characteristic symptoms of the disease, and a number of clinical studies. The most important factor is the presence of characteristic antibodies in the blood. Often it is necessary to do a biopsy to exclude thyroid cancer, when it is strongly condensed.
Based on biochemical studies, treatment is prescribed by an endocrinologist. It can be conservative or surgical. Conservative treatment is hormone replacement therapy. It can last for years or even a lifetime. When the density of goiter is significantly increased, the possibility of a tumor is not excluded, and, most importantly, if the patient has symptoms of suffocation, shortness of breath, compression of the neck, it is better to resort to surgical intervention.
Features of the disease
This disease got its name due to the Japanese surgeon Hashimoto, at the beginning of the last century. The doctor first described the signs of this disease. The disease, as a rule, affects mainly adults, whose age has overstepped the mark of 50 years. The disease is observed in approximately 1% of all people. Men suffer from goiter Hashimoto several times less than women.
The clinical varieties of this disease include hyperplastic (its other name is hypertrophic) form of autoimmune thyroiditis, in which the patient has a goiter. The focal form of the goiter Hashimoto looks like a lesion of one lobe in the thyroid gland.
As for the trophic variety, in this situation the tissues of the organ are replaced by connective tissues. The gland becomes smaller in size due to the death of a large number of thyrocytes. Hormonal deficiency is formed, which is called hypothyroidism.
Symptoms of the disease
The initial stages of this state occur completely unnoticed by humans and do not appear for a long time.
One of the most basic signs of Hashimoto's goiter is a change in shape or an increase in the size of the thyroid gland.
There is also severe weakness and general fatigue. Most often, these changes are invisible to the patient.
Autoimmune thyroiditis is detected randomly in most cases. If the goiter has reached a significant size compared with the normal state, patients come to the doctor for complaints of discomfort and pain in the neck.
Goiter can compress the esophagus and trachea - organs that are in this area.
In addition to other signs, the following are distinguished:
Severe and persistent dyspnea. Frequent constipation. Problems with memory. Dysfunction of the reproductive system. Worsening of the skin. Strong puffiness. Fragility and thinning of nails. Worsening of the hair (they become brittle and become dull in color).
If it was noticed at least one condition from the list above, you should consult a doctor.
Problems of this nature deals with the endocrinologist. He will refer to the diagnosis and carry out the necessary treatment in case of such a problem.
The causes of the pathology
The main symptom of the disease - an increase in the size of the thyroid gland
Modern specialists have found that the disease, like diffuse toxic goiter, is due to immunological control disorders, which are congenital. Both diseases are not associated with the endocrine system and are combined with other pathological conditions of autoimmune origin.
In the body of a patient with goiter Hashimoto, special antibodies begin to form, which “conflict” with the components of the thyroid gland. As a result, an autoimmune disease appears.
The reasons that can cause this disease are:
Toxic diffuse goiter, which is already present in a patient. Pathology of an autoimmune character in a patient. Infectious diseases and inflammation processes in the body. Operations performed on the thyroid gland. Heredity (relatives suffering from the same disease)
All of the above are risk factors for Hashimoto goiter.
Treatment of the disease
The primary diagnosis will be made only if the thyroid gland is compacted in several places, the volume of such an organ has increased or hypothyroidism has appeared.
Studies conducted in the laboratory, show that antibodies are in the blood in an amount several times higher than normal. Such an examination is carried out in order to exclude the patient from the likelihood of cancer.
Also in medical institutions, a puncture biopsy is performed to determine the ability of the thyroid gland to carry out its work normally.Such a study includes a reaction to radioactive iodine, the amount of thyroid hormones and the thyrolebin sample.
Treatment of the disease is carried out by a specialist after examination.
Treatment of the disease can last for several years. For each patient, the required dosage of hormones is selected individually. At the same time, the medical institution will take into account the age at which the patient is, as well as whether the disease is aggravated by diseases of the cardiovascular system.
Levothyroxine is prescribed on 75-100 mg per day. For every kilogram of patient weight should be 1.6 μg of this drug.
The course of treatment is monitored in a medical institution by determining the level of hormones in a patient’s blood. This procedure is carried out once every two months. In addition, the patient with goiter Hashimoto was recommended to take drugs of the glucocorsteroid type. Basically prednisolone is prescribed, the daily intake of which should be about 40 mg per day.
In some cases, the use of stimulating agents.
If there is a suspicion that the patient has a malignant formation, surgical intervention is indicated.
Such surgical manipulations are also carried out if, as a result of a strong increase in the goiter, the trachea and esophagus are squeezed.
In this case, the surgeon must have many years of experience and good qualifications, since as a result of such an operation, many blood vessels will be affected. Otherwise, incorrectly performed surgical procedures can lead to damage to the parathyroid gland or paralysis of the vocal cords.
In addition, with its help it is impossible to completely get rid of the problem. No matter how successful she is, the patient will have to take prescribed medications throughout her life. Therefore, without extreme necessity, it is better not to resort to surgical treatment.
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Hashimoto goiter is a chronic inflammatory process caused by negative autoimmune reactions localized in the thyroid gland.
In this diagnosis, the body's immunity produces antibodies to the cellular structures of its own thyroid gland, perceiving it for a foreign organ.
Such a cellular attack does not pass without a trace - an inflammatory process develops in the tissues of the gland, the cells of the organ begin to die.
The second name for Hashimoto's goiter is autoimmune thyroiditis or Hashimoto thyroiditis. This disease often becomes the impetus for the development of primary hypothyroidism.
According to statistics, this disease is more often diagnosed among women. Men get sick with this endocrine pathology much less often.
Modern endocrinologists believe that the main cause of the disease is the congenital features of the body that cause disturbances in the immunological system, which brings together diffuse toxic goiter and Hashimoto's goiter according to the general mechanism of development.
Often both of these diseases are accompanied by background autoimmune diseases of non-endocrine origin - myasthenia gravis, vitiligo, rheumatoid arthritis, and much more.
Predisposing factors for the development of Hashimoto's disease include the following disadvantages in the endocrine system:
autoimmune pathologies, surgery on the thyroid gland, diffuse goiter in the past, unfavorable heredity - blood relatives were ill or suffer from autoimmune thyroiditis, inflammatory and infectious phenomena of a chronic nature in the body.
In 1912, the disease was first described by a Japanese doctor, Hashimoto. He also began to study the nature of this disease, and his work was later supported and continued by other scientists.
They managed to determine that Hashimoto's thyroiditis develops against the background of a serious failure of human immunity.
Normally, the immune system is engaged in the search and elimination of foreign substances and bodies entering the body. In case of failure, the immunity perceives the thyroid gland as a foreign object, and begins to produce its own antibodies against it.
As a result of this negative impact, the functions of the endocrine organ are inhibited, as a result of which hypothyroidism develops.
So, what factors can cause the failure of the immune system, the mechanism of action of which is described above:
Viral environment, Autoimmune pathologies, Radiation exposure, Negative toxic effects, Nicotine addiction, Chronic foci of untreated infections, Long-term use of certain medications, Excessive amount or, on the contrary, iodine deficiency.
Hashimoto goiter classification
Such a classification is as follows:
hyperplastic (otherwise hypertrophic) form of the disease, which is characterized by the formation of goiter, trophic form, against which the thyroid gland is reduced in volume due to the massive death of thyrocytes, while the dead organ tissue replaces the connective tissue, hypothyroidism develops, focal form, with which is damaged is one of the lobes of the gland.
Symptoms of the disease
At the onset of the disease, most people do not know that they are sick, since the symptomatic picture of Hashimoto's goiter will be hidden.
But at the stage of reducing the production of hormones by the gland, negative changes in the body make themselves felt in the form of the following symptoms:
depression, apathy, drowsiness, fatigue, swelling of tissues, indigestion, constipation, loss of working ability, overweight, hair loss, deterioration of joint flexibility, problems with the act of swallowing.
The disease progresses slowly, and at the primary stage it is almost asymptomatic. Patients can only notice fatigue and drowsiness. At the same time, the thyroid gland begins to grow, and soon this situation cannot go unnoticed.
The goiter becomes large, and begins to exert pressure on the internal organs, the trachea and the esophagus first of all suffer, as a result of which the patient has complaints of shortness of breath and persistent discomfort in the neck.
On palpation of the organ, the endocrinologist notes a noticeable growth of the thyroid gland, however, the patient may not complain at all about the painful sensations.
If the above symptoms have appeared, it is better not to hesitate and seek help from a doctor for diagnosis and treatment prescription.
It is believed that Hashimoto goiter is a fairly harmless endocrine disease, as long as the level of hormones in the blood shows a condition typical of euthyroidism.
As soon as it comes to thyrotoxicosis and hypothyroidism, urgent conservative treatment must be initiated to prevent the development of possible complications.
A neglected, untreated disease often causes serious arrhythmias, heart failure, up to and including the development of a heart attack, atherosclerosis, and other vascular pathologies.
In addition, the lack of proper treatment can affect a person’s intellect, namely lead to dementia - persistent dementia.
If the level of hormones in thyroiditis Hashimoto is within the normal range, then no specific treatment is required.
Levothyroxine in the form of hormone replacement therapy is indicated in the case of a decrease in the active phase of the autoimmune process.
If hypothyroidism is diagnosed against the background of the disease, indicating insufficient gland hormone production, Levothyroxine is definitely needed.
The dose of the drug is chosen individually, depending on the level of hormones in the patient's body, and its body weight.
In the case of a combination of Hashimoto goiter and thyroiditis,
the patient is prescribed glucocorticosteroids (most often Prednisolone).
In combination with the prescribed therapy can be used immunostimulants, successfully proven in the treatment of this disease. These include T-activin.
If we are talking about a serious compression of internal organs, in which the goiter reaches impressive size and continues to grow uncontrollably, it is necessary to promptly treat it.
Also, the need for surgical intervention is indicated in cases of suspected malignant degeneration of goiter.
Hashimoto's disease: a characteristic of the disease
The human immune system is designed in such a way that it deals with protective functions and destroys all foreign aggressive cells and tissues in the body. When negative changes occur in the well-coordinated work of this system, the immune system begins to behave aggressively towards the human's native organ (thyroid gland). Gland tissues are saturated with leukocytes. The activity of white blood cells leads to inflammation of the thyroid gland (it is an autoimmune thyroiditis).
As a result of developing inflammation, some of the cells of the gland die. Surviving cells are not able to cope with the necessary amount of hormonal production, which requires the body. As a result, hormonal deficiency or autoimmune hypothyroidism develops.
Stages of AIT Development
There are 3 stages of the clinical development of autoimmune thyroiditis:
- Suddenly and dramatically increased hormonal activity. At this stage, an elevated level of antibodies is observed. The thyroid gland is still a healthy body, so it actively holds the defense method of abundant production of hormones that enter the blood. Such hyperactive behavior of the thyroid gland is accompanied by nervousness and excitement of the patient, arrhythmia, weight loss, dry skin, itching.
- The second stage is the so-called latent course of the disease. This stage usually lasts for several years. The patient has a general malaise, fatigue. Autoimmune hypothyroidism develops in the second stage of the disease.
- The third stage occurs when the functions of the thyroid gland are greatly reduced, depressed. The patient feels chronic fatigue, thinking is inhibited, the person is constantly prone to sleep. In women, the cycle of menstruation is disturbed.
Autoimmune thyroiditis forms
There are three forms of goiter Hashimoto:
- Hypertrophic or hyperplastic form AIT. This form is characterized by an increased level of cytostimulating antibodies.
- An atrophic form is observed when connective cells appear instead of thyroid tissue. As a result of atrophy and death of thyroid cells, the thyroid gland is reduced in size. Subsequently, hypothyroidism develops. In the atrophic form, cytotoxic antibodies predominate.
- A focal form occurs when a partial lesion of the thyroid gland occurs. This form is characterized by a different ratio of cytostimulating and cytotoxic antibodies.
How is Hashimoto's disease treated in women of childbearing age?
Women who are planning to become mothers should definitely undergo an examination of the thyroid gland.
In case of detection of goiter Hashimoto, it is necessary to start taking the necessary drugs before pregnancy.
In the body of a pregnant woman there is an increased load on the thyroid gland of the mother. The need for hormone production increases significantly, their lack causes a deficit.
Such a situation may lead to undesirable consequences: abortion, underdevelopment of the fetus.
In other cases, when the hormone deficiency occurs, the mother’s body will begin to exploit the fetus’s thyroid gland as a donor. As a result, the child at birth will already have a thyroid gland with impaired functions.