Hashimoto's thyroiditis classification
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Furqan M M. M.B.B.S[2]
Overview
On the basis of the etiology, Hashimoto's thyroiditis can be classified as primary or secondary types. Rarely, Hashimoto's thyroiditis can be categorized under the polyglandular syndromes.
Classification
Hashimoto's thyroiditis (HT) can be classified on the basis of the etiology to the primary and secondary types as follows:[1]
Primary
Primary HT is the most common form of thyroiditis and comprises the cases that do not currently have identifiable causes. Primary HT encompasses a spectrum of the following main types:
Two forms of painless thyroiditis, sporadic and postpartum thyroiditis were considered the form of Hashimoto's thyroiditis. These are now regarded as different from Hashimoto's thyroiditis.
Secondary
Secondary HT is of more recent description. It includes the forms where an etiologic agent can be clearly identified. It is more commonly iatrogenic and induced by the administration of:
- Immunomodulatory drugs (e.g, interferon-alpha)
- Monoclonal antibodies that block CTLA-4
- Cancer vaccines
Polyglandular autoimmune syndromes
In rare cases, Hashimoto's thyroiditis may be associated with other endocrine disorders caused by the immune system. On the basis of the involvement of other endocrine disease involvements, Hashimoto's thyroiditis may be classified under the polyglandular autoimmune syndromes. [2]
- Type 2 polyglandular autoimmune syndrome (PGA II):
- Type 1 polyglandular autoimmune syndrome (PGA I):
- Hashimoto's disease/hypothyroidism
- Adrenal insufficiency
- Fungal infections of the mouth and nails
- Hypoparathyroidism
References
- ↑ Caturegli P, De Remigis A, Rose NR (2014). "Hashimoto thyroiditis: clinical and diagnostic criteria". Autoimmun Rev. 13 (4–5): 391–7. doi:10.1016/j.autrev.2014.01.007. PMID 24434360.
- ↑ Kahaly GJ (2009). "Polyglandular autoimmune syndromes". Eur. J. Endocrinol. 161 (1): 11–20. doi:10.1530/EJE-09-0044. PMID 19411300.