Centres of Excellence -> Endocrinology and Diabetes -> Hashimoto's disease

Hashimoto's disease (Chronic autoimmune thyroiditis)

It is named after the Japanese doctor Hakuru Hashimoto, who first described it in 1912.

Hashimoto's disease is one of the most common autoimmune disorders in the general population. The disease occurs about 15 times more often in women compared to men, most often between the ages of 30 and 50 with a pronounced component of family inheritance and transmission to offspring. In certain areas, up to 10% has this disease.

Basic characteristics of Hashimoto's disease

The basic characteristic of Hashimoto's disease is the destruction of thyroid tissue by chronic autoimmune inflammation, i.e. the mobilization of our body's defense system in which its own inflammatory cells (T and B lymphocytes) and B-lymphocyte products (antibodies) attack and destroy the thyroid gland. The disease is associated with changes in the HLA-DR5, PTPN22 genes, genes for thyroglobulin and vitamin D receptors, as well as a CTLA-4 (Cytotoxic T-lymphocyte Antigen-4) gene mutation. CTLA-4 gene mutations lead to a decrease in the inhibitory activity of inflammatory cells (T-lymphocytes), which results in their excessive activity in the destruction of their own thyroid. It can be triggered by psychological stress, pregnancy, chronic inflammatory processes and the use of drugs and vaccines.

Although in practice it most often results in reduced thyroid function, i.e. reduced production of T4 and T3 hormones (there are physical slowness, increased hair loss, changes in the skin and nails, slowed digestion, weight gain, disturbed menstrual cycle, sexual dysfunction) and as such is treated.  The development of the disease is also possible in the form of increased thyroid function, but also its normal function.

Liječenje Hashimotove bolesti u Sv. Katarini

Symptoms and complications of Hashimoto's disease

Patients can be without any symptoms and present with complaints of varying degrees such as chronic fatigue, feeling of exhaustion, feeling sleepless after a good night's sleep, bad mood or depression and reduced ability to concentrate.

Rare complications of Hashimoto's disease include the development of malignant tumors of the lymphatic cells (primary Non-Hodgkin's lymphoma of the thyroid gland) and Hashimoto's encephalopathy (a special form of Hashimoto's disease that can develop in two basic clinical presentations: recurrent stroke-like neurological disturbances and a progressive form of the disorder dominated by psychiatric symptoms in addition to dementia symptoms).

Diagnostic procedure and treatment of Hashimoto's disease

The diagnostic procedure includes a specialist and ultrasound examination of the thyroid gland, determination of TSH and eventually, thyroid hormone, sometimes scintigraphy and less often, thyroid puncture. Genetic testing is also possible. In the blood, in 30-40% of patients, are found reduced iron values with/without developed symptoms of anemia and elevated fat levels (cholesterol).

The treatment of Hashimoto's disease is almost always lifelong and is based on the treatment of its consequences, usually reduced or less often increased thyroid function. It should also be noted that in 10% of cases, the diagnosis of Hashimoto's disease entails an increased risk for the development of other autoimmune diseases (celiac disease, type 1 diabetes, autoimmune inflammation of the liver, autoimmune anemia, multiple sclerosis, rheumatoid arthritis, etc.).

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