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Category: Volume 07 Issue 11 November 2019
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Title: Ultrasound in Hashimoto’s Thyroiditis in Young Female Presented as Hypothyroidism- A Case Report with Review

Authors: Pranav Kumar Dave, Vivek Gupta, R Mishra, M Jain, M Bapat, P Rajpali, M Tilgam, P Gupta, A Patidar, J Verma, C Dave, P Saxena, V Agrwal

 DOI: https://dx.doi.org/10.18535/jmscr/v7i11.146

Abstract

Thyroiditis is inflammatory disorder of thyroid with wide spectrum of clinical presentation. Thyroid function may be normal, high or low in valve. The presentation of symptoms, family history is of importance. Hashimoto’s thyroiditis is not an uncommon cause of hypothyroidism in young population. Ultrasound is the imaging modality of choice in diagnosis of thyroid disorders.  Thyroid ultrasonography is a simple, non -invasive, reproducible and without use of radiation with high sensitivity in diagnosis of thyroiditis. The purpose of this study was to determine the sensitivity and specificity of gray scale sonographic findings in Hashimoto’s thyroiditis and its clinico-cytological correlation.

Introduction: Thyroiditis is defined as the inflammation of the thyroid gland and classified as acute/sub acute, chronic or autoimmune thyroiditis. Autoimmune thyroid disease AITD includes two major clinical presentations; Grave’s Disease (GD) and Hashimoto's Thyroiditis (HT)1. The prevalence of AITD is approximately 5% with  clinical presentation of  hyperthyroidism or hypothroidism2. The pathogenesis is not very clear, there may be environmental factors, infection, drugs, smoking, etc. ,could trigger AITD in susceptible persons3.TUS findings in HT includes diffuse enlargement  with decreased echogenicity, heterogeneity with hypervascularity and presence of hypo echoic micro nodules with echogenic rim. Cytological diagnosis is superior in children and as in initial stages of HT, antibody production may be limited. FNAC is quick, cost-effective and highly sensitive in diagnosis of HT4.Most of the HT cases are in young and pre-menopausal females and more prone for poor obstetrical and fetal outcome, therefore early diagnosis of HT on clinical, TUS and cytology is of importance for supplementation of thyroxin  for associated hypothyroidism.

Keywords: Hashimoto’s thyroiditis HT, Grave's Disease GD, Autoimmune Thyroid disease AITD, Hypothyroidism, Thyroid Ultra Sonography-TUS, CD Color Doppler.

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Corresponding Author

Dr Pranav K Dave

Asso. Prof. Deptt. of Radiology