Hashimoto’s Thyroiditis

Abstract

Hashimoto’s thyroiditis or chronic autoimmune thyroiditis is the most common cause of hypothyroidism in the United States and a common cause of goiter. It was described by Dr. Hashimoto in 1912 as a lymphocytic infiltration of the thyroid gland with goiter. It has since been well established as an autoimmune disease and circulating antibodies against the thyroid (microsomal or peroxidase and thyroglobulin antibodies) can be found in the majority of cases. Like most thyroid diseases, it is much more common in women than in men, with a sex ratio of 6 or 7 to 1. It can present with goiter alone, goiter and hypothyroidism, or occasionally with transient hyperthyroidism followed by hypothyroidism. Subclinical hypothyroidism is seen in some cases. The goiter is most often diffuse, but Hashimoto’s thyroiditis may present with multinodular goiter (MTNG) or a single nodule. The case discussions in this chapter illustrate varying presentations of the disease and an approach to diagnosis and treatment.