Hashimoto's thyroiditis natural history, complications and prognosis
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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
Hashimoto's thyroiditis usually begins slowly and may progress to hypothyroidism. Complications include heart failure, lymphoma, myxedema, and cervical compression.
Natural History
The disease begins slowly. The patient usually has the neck swelling and presents with symptoms of hypothyroidism such as fatigue, weight gain, constipation, and dry skin. Some patients may also present with hyperthyroidism. It may take months or even years for the condition to be detected. If left untreated, Hashimoto's thyroiditis may lead to muscle failure including heart failure, other features associated with hypothyroidism and complications such as myxedema Coma and Hashimoto's encephalopathy.[1]
Complications
Complications that can develop as a result of Hashimoto's thyroiditis are:[1][2][3][4][5]
- Hypothyroidism
- Hyperthyroidism
- Heart failure
- Myxedema Coma
- Tracheal and/or esophageal compression
- Hashimoto's encephalopathy
- Papillary thyroid carcinoma (PTC)
- Thyroid lymphoma
Prognosis
The outcome is usually very good. The disease stays stable for years. If it does slowly progress to thyroid hormone deficiency (hypothyroidism), it can be treated with thyroid replacement therapy.
References
- ↑ 1.0 1.1 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.
- ↑ Kirshner HS (2014). "Hashimoto's encephalopathy: a brief review". Curr Neurol Neurosci Rep. 14 (9): 476. doi:10.1007/s11910-014-0476-2. PMID 25027262.
- ↑ Lun Y, Wu X, Xia Q, Han Y, Zhang X, Liu Z, Wang F, Duan Z, Xin S, Zhang J (2013). "Hashimoto's thyroiditis as a risk factor of papillary thyroid cancer may improve cancer prognosis". Otolaryngol Head Neck Surg. 148 (3): 396–402. doi:10.1177/0194599812472426. PMID 23300224.
- ↑ Ahmed R, Al-Shaikh S, Akhtar M (2012). "Hashimoto thyroiditis: a century later". Adv Anat Pathol. 19 (3): 181–6. doi:10.1097/PAP.0b013e3182534868. PMID 22498583.
- ↑ Chiang B, Cheng S, Seow CJ (2016). "Commonly forgotten complication of Hashimoto's thyroiditis". BMJ Case Rep. 2016. doi:10.1136/bcr-2016-217568. PMID 27797845.