Hashimoto’s thyroiditis / chronic lymphocytic thyroiditis / autoimmune thyroiditis

Summary

Hashimoto’s thyroiditis is a chronic inflammatory autoimmune thyroid disease in which the immune system attacks and destroys the thyroid gland. The thyroid then produces too little hormone and metabolism is slowed. It is the most common of all the thyroid conditions in the US and women are affected 10 times more often than men. Most diagnoses occur between the ages of 30-50 and prevalence increases with age in both women and men. Symptoms, which often develop gradually, may include weight gain, cold sensitivity, tingling in the hands and feet, fatigue, hair loss, dry hair, fertility problems, and difficulty concentrating. Thyroid hormone should be monitored in women who plan pregnancy. Low thyroid function can affect the development of the baby. Post-partum thyroiditis can develop in the 12 months following childbirth. Women who are having trouble conceiving should also have their thyroid levels checked as thyroid hormone levels can affect ovulation.

(2022, Autoimmune Association)

Symptoms

Hashimoto's disease progresses slowly over the years. You may not notice signs or symptoms of the disease. Eventually, the decline in thyroid hormone production can result in any of the following:

• Fatigue and sluggishness

• Increased sensitivity to cold

• Increased sleepiness

• Dry skin

• Constipation

• Muscle weakness

• Muscle aches, tenderness and stiffness

• Joint pain and stiffness

• Irregular or excessive menstrual bleeding

• Depression

• Problems with memory or concentration

• Swelling of the thyroid (goiter)

• A puffy face

• Brittle nails

• Hair loss

• Enlargement of the tongue

(2022, Autoimmune Association)

Diagnostic Criteria

Under Investigation

Diagnostic Tests

Under Investigation

Organized Autoimmunity

(Alternative Autoimmune Disease Classification: FIEM, MIEM or BIEM)

1. sex predominance (is an autoimmune disease primarily found in genetic Females, Males, or equally in Both?)

   1. Female, Male, or Both. (Autoimmune Association, 2022)

2. Inherited gene variations that cause increased susceptibility

   1. Human Leukocyte Antigen (HLA) Associations

      1. Under Investigation

   2. Other Gene Variations (mutations)

      1. CTLA4 cytotoxic T-lymphocyte associated protein 4 [ Homo sapiens(human)] “This gene is a member of the immunoglobulin superfamily and encodes a protein which transmits an inhibitory signal to T cells. The protein contains a V domain, a transmembrane domain, and a cytoplasmic tail. Alternate transcriptional splice variants, encoding different isoforms, have been characterized. The membrane-bound isoform functions as a homodimer interconnected by a disulfide bond, while the soluble isoform functions as a monomer. Mutations in this gene have been associated with insulin-dependent diabetes mellitus, Graves disease, Hashimoto thyroiditis, celiac disease, systemic lupus erythematosus, thyroid-associated orbitopathy, and other autoimmune diseases.” (National Institutes of Health, 2023)

3. Gene Triggering Environmental Exposures

   1. Infections

      1. Under Investigation

   2. Toxins

      1. Under Investigation

   3. Stress

      1. Under Investigation

4. Multiple interactive and destructive immune system pathologies

   1. Under Investigation

Tissue-Type or Cell-Type Attacked

(2021, Rojas et. al)

PPV: positive predictive value (the probability that a patient with a positive (abnormal) test result actually has the disease). NPV: negative predictive value (the probability that a person with a negative (normal) test result is truly free of disease). (1999, NY State Department of Health). AUC: area under the curve.

Treatment(s)

Under Investigation

Managing Specialist(s)

Under Investigation

Research Authors

Under Investigation

Research Institutions

Under Investigation

Average Time from Symptom Onset to Diagnosis

Under Investigation

Last Updated

February 17, 2023

References

CTLA4 cytotoxic T-lymphocyte associated protein 4 [ Homo sapiens (human) ]. National Institutes of Health, National Library of Medicine, National Center for Biotechnology Information, Gene Database. (2023). Retrieved February 17, 2023 from https://www.ncbi.nlm.nih.gov/gene/1493

Disease Screening-Statistics Teaching Tools. New York State Department of Health. (1999, April). Retrieved November 15, 2022, from https://www.health.ny.gov/diseases/chronic/discreen.htm

Hashimoto’s Thyroiditis. Autoimmune Association. (2022, September 02). Retrieved November 16, 2022, from https://autoimmune.org/disease-information/hashimotos-thyroiditis/

Rojas M, Ramírez-Santana C, Acosta-Ampudia Y, Monsalve DM, Rodriguez-Jimenez M, Zapata E, Naranjo-Pulido A, Suárez-Avellaneda A, Ríos-Serna LJ, Prieto C, Zambrano-Romero W, Valero MA, Rodríguez Y, Mantilla RD, Zhu C, Li QZ, Toro-Gutiérrez CE, Tobón GJ, Anaya JM. New insights into the taxonomy of autoimmune diseases based on polyautoimmunity. J Autoimmun. 2022 Jan;126:102780. doi: 10.1016/j.jaut.2021.102780. Epub 2021 Dec 16. PMID: 34923432.