Hashimoto thyroiditis is an autoimmune disease whose signs are those of hypothyroidism.
Eliminated from season 14 of “Dance with the stars” Friday April 11, Julie Zenatti said that the Hashimoto thyroidite from which she suffers complicated her participation in the show. Hashimoto’s disease represents around 20% of thyroid diseases and “Preferentially affects women with a risk at least 10 times higher than that of men”details Professor Fabrice Menegaux, visceral and digestive surgeon. Causes, signs, diagnosis and treatment of Hashimoto thyroiditis.
Definition: What is Hashimoto’s thyroidite?
Hashimoto thyroiditis is an autoimmune disease caused by the action of antibodies that attack its own cells, in this case located in the thyroid. We are also talking about lymphocytic chronic thyroiditis. It was described for the first time in 1912 by a Japanese doctor whose name it bears, it manifests itself by the chronic inflammation of the thyroid gland which can generate an increase in its size (goiter) but more frequently a decrease in its volume. The signs are essentially reflected in hypothyroidism.
What are the signs of Hashimoto thyroidite?
Symptoms are those of hypothyroidism:
- weight gain;
- generalized state of fatigue;
- depressed symptoms,
- swollen, puffy face;
- Increase in the size of the fingers, which are sought;
- Drought of the skin with decrease in the phenomenon of sweat;
- transit slowdown with frequent constipation;
- muscle pain;
- slowdown in heart rate;
- modification or interruption of rules;
- Fragile and brittle nails.
“The increase in thyroid volume is rare but can be responsible for compressive signs with respiratory discomfort or swallowing disorders“Add Professor Menegaux.
The cause of Hashimoto syndrome is the presence of blood antibodies that attack thyroperoxidase (anti-TPO antibodies), an enzyme entering into the manufacture of thyroid hormones and, on a lower scale, thyroglobulin, a precursor of thyroid hormones. Thus, the manufacture of these hormones is disrupted and the result is, in the majority of cases, hypothyroidism. Hashimoto thyroiditis sometimes associates other attacks such as type 1 diabetes, vitiligo, adrenal insufficiency or rheumatoid arthritis.
The diagnosis of Hashimoto syndrome is carried out by practicing blood assay of thyroid hormones which are lowered (T3 and T4), as well as a blood test of TSH which is increased. The blood dosage of thyroid antibodies, anti-TPO antibodies, confirms the diagnosis when high. “An ultrasound of the thyroid highlights a small pseudonodonodular thyroid, the increase in volume of the gland being rare. We must look for the presence of a nodule which could justify a puncture for cytological examination, and the lymph nodes of the neck are often increased in volume, of inflammatory, without disturbing characteristics”details our interlocutor. Thyroid scintigraphy has no interest in practice.
Treatment consists in correcting hypothyroidism by administering for many years, most often for life, thyroid hormones, such as levothyroxine, identical to that produced by the thyroid gland, in order to compensate for the insufficiency of the gland production. This treatment does not act on the origin of the disease, the cause being immune, but makes it possible to find a normal rate of thyroid hormones in the blood and makes it possible to lead a normal life. Treatment also depends on the volume of goiter: only rare bulky and compressive goats may require surgical management in the form of a thyroidectomy. In the vast majority of cases, the treatment of Hashimoto thyroiditis is medical and simply uses thyroid hormones. The therapeutic dose of prescribed drugs must be respected to the letter. The treatment adapts to each patient according to the blood dosages of the TSH, T4 and T3. The doctor will thus adapt the dosage according to the evolution of manifestations and the results of blood dosages.
Thank you to Professor Fabrice Menegaux, head of the general, visceral and endocrine surgery department and head of the service of the surgery center of the La Pitié Salpêtrière hospital – Charles Foix.
