CLINICAL STUDY OF HASHIMOTO???S THYROIDITIS & ITS MANAGEMENT

Abstract

M. Purnaiah1, G. Rakesh2

INTRODUCTION
Hashimoto’s Thyroiditis is a well-known clinical condition affecting the thyroid gland predominantly in women during 4th decade & is often under diagnosed due its wide spectrum of clinical features. It could present as a multinodular goitre, diffuse goitre, or as a solitary nodule with features of Hypothyroidism, Hyperthyroidism or Euthyroid state.
AIMS
1. To detect HT by FNAC, Antibody titers finally by Histopathology of excised Thyroid gland.
2. To know its various clinical features.
3. To study Sex ratio & Age it affects.
4. Management i.e. by conservative or surgical.
5. Complications & malignant transformation including Lymphomas.
MATERIALS & METHODS
60 patients were taken for 2 years’ period from March 2014 to Feb 2016 attending Government General Hospital-Nizamabad; Telangana State.
OBSERVATIONS
??? 56 case are females, 4 cases are males; common age is 30-39 yrs., >50 yrs.-2 cases.
??? All cases presented with swelling in front of neck, only 5 had toxicity, 2 had obstructive symptoms. None had voice change.
??? 36 Cases- 60% had MNG, 18 Cases- 30% diffuse goitre and 6 cases- 10%- solitary nodule.
??? The Hypothyroid, Euthyroid & Hyperthyroid state here are 48%, 44% & 8% comparative to Fenn et al -44%, 47% and 7%,
??? FNAC- was positive 90% here where as Lakshman Rao et al study has 77%.
??? We had 80% Anti Thyroid Antibodies positivity, others shown 63% and 84%.
MANAGEMENT
All are put on Hormone-Thyroxine replacement or suppression therapy and all patients found to be clinically Euthyroid during follow up. All patients showed decrease in size of gland except those with MNG.
8 patients underwent surgery- Subtotal Thyroidectomy. Of these 6 were Colloid goiters, later on diagnosed as HT by final HPE. One case was operated for cosmetic reason and the other for obstructive symptoms which was noticed to be lymphoma after HPE.

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