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Disease
Hashimotos Disease
Aka Chronic Lymphocytic Thyroiditis
Autoimmune disease causing primary
hypothyroidism
Primary cause of hypothyroidism in US
1 in 1000
Symptoms
Fatigue
Weight gain
Pale/puffy face
Feeling cold
Joint/muscle pain
Constipation
Dry/thinning hair
Memory problems
Pathophysiology
Immune system attacks the thyroid gland, causing inflammation and preventing it from
producing thyroid hormones
T3 = triiodothyronine
T4 = thyroxine
Hashimotos Histology
Risk Factors
Family history
HLA-DR5 gene
CTLA-4 gene (Cytotoxic T-lymphocyte Antigen-4) = negative regulation of T Cells
Also associated with Type 1 DM
Environmental Factors
High iodine intake?
Selenium deficiency
Chromosomal Disorders
Diagnosis
History + Physical exam + Presence of a goitre
Blood testing for Thyroid-Stimulating hormone (TSH), free T3/T4
High TSH and low T3/T4
Treatment
Thyroid Hormone Replacements (synthetic T4)
Levothyroxine, triiodothyronine, desiccated thyroid extract
Oral, once per day to keep TSH under 3.0
Must be checked ~every 6 months (too much can cause osteoporosis and
arrhythmias)
Other:
Selenium
Low-level laser therapy
Gluten free diet
Prognosis
Sources
https://en.wikipedia.org/wiki/Hashimoto's_thyroiditis#Pathophysiology
http://www.niddk.nih.gov/health-information/health-topics/endocrine/hashimotosdisease/Pages/fact-sheet.aspx
http://www.omim.org/entry/140300
http://www.omim.org/geneMap/8/401?start=-3&limit=10&highlight=401
http://ghr.nlm.nih.gov/gene/HLA-DRB1
http://emedicine.medscape.com/article/120937-overview