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Penyakit autoimun yang menyebabkan

inflamasi kronis pada kelenjar tiroid

Usia 30-60 tahun


7x >
risiko pd px dg komorbid penyakit
autoimun lain:

Vitiligo
RA
DM tipe 1
Anemia pernisiosa
Penyakit Addison
ITP
SLE, dll

Genetik
Lingkungan

Infeksi
Kehamilan
Iodin
Rokok

Paparan iodin & lama


iodinasi thyroglobulin
dianggap Ag proses
autoimun aktif

Defisiensi selenium
aktivitas selenoprotein
(eg. glutation
peroksidase) H2O2
inflamasi

TSBAb cegah TSH


menempel ke TSH-R tp tdk
menstimulasi sel tiroid
hipotiroid

TSH tdk bisa inhibisi


apoptosis atrofi tiroid

Mechanism

Symptoms

Signs

Slowing of metabolic processes

Fatigue and weakness


Cold intolerance
Dyspnea on exertion
Weight gain
Cognitive dysfunction
Mental retardation (infant)
Constipation
Growth failure

Slow movement and slow speech


Delayed relaxation of tendon reflexes
Bradycardia
Carotenemia

Accumulation of matrix substances

Dry skin
Hoarseness
Edema
Nerve entrapment

Coarse skin
Puffy facies and loss of eyebrows
Periorbital edema
Enlargement of the tongue

Other

Decreased hearing
Myalgia and paresthesia
Depression
Menorrhagia
Arthralgia
Pubertal delay
infertility

Diastolic hypertension
Hair loss
Pleural and pericardial effusions
Ascites
Galactorrhea
Ataxia

Hormon TSH (paling sensitif u/ hipotiroid),


T3, T4
ATPO (antithyroid peroxidase)
TGAB (antithyroglobulin)
Biopsi (FNAB)

Hormon tiroid sintetik (T4, T3) T4 lbh


sering digunakan
1-2 ug /kg body weight/day
75 125 ug/day in women
125 200 ug/day in men

Selenium
Surgery

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