Chronic Thyroiditis And Its Reaction To The Immune System

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Chronic thyroiditis and its reaction to the immune system

Summary

Hashimoto chronic thyroiditis is a thyroid gland condition which is an endocrine organ responsible for producing thyroid, thyroxine and triiodothyroning hormone, this is affected by the immune system that makes this antibody attack causing hyperthyroidism or hypothyroidismThe chronic thyroiditis being the most common cause of hypothyroidism, hypothyroidism is a condition in which the thyroid gland cannot produce enough thyroid hormone. This has the function of regulating the metabolic process required by thebody.

This disorder affects about 2% of the population in most cases are women with a prevalence of between 10 – 15 times higher in ages between 30 and 50 years and with a difference of 10 – 15 years in men in men, although this condition may appear at any age or sex.

The symptoms that frequent can be different such as: fatigue and laziness, greater sensitivity to cold hair loss, weight gain, muscular weakness, depression and memory failures, physically the most notable symptoms can be the swelling of the partFront of the throat (goiter), its complication can cause a complication to swallow or breathe as well as heart problems due to an increase in low density lipoprotein cholesterol levels (bad cholesterol). For its diagnosis, tests are evaluated in the laboratory consisting of hypothyroidism such as a high level of TSH in blood with low thyroid hormone levels.

Its treatment can be very effective as cheap for affected patients such as thyroid hormone replace. 

Introduction

Chronic thyroiditis or also called Hashimoto’s thyroiditis "is an autoimmune disease. This means that the immune system, which generally protects the body and helps fight diseases, produces antibodies and attacks the thyroid gland. The thyroid gland then loses the ability to produce enough thyroid hormones, which can cause hypothyroidism. Hypothyroidism means that the thyroid gland does not produce enough thyroid hormones to meet body needs."

“It was first described in 1912 by the DR. Hakaru Hashimoto, who detected the presence of a lymphocyte infiltrate that called lymphomatous struma in the thyroid of these patients. Subsequently, in 1956 Doniach and Roitt identified the thyoglobulin as the main autoantigen that triggered the autoimmune process;A year later a second autoantigen was found in the microsomal fraction, currently known as thyroid peroxidase." 

Its epidemiology in developed countries such as the United States has significantly affected a higher percentage of women compared to men approaching 5 to 10 times higher in the case of the female gender, in women of reproductive age it is relatively common, with aPrevalence from 6% to 20%, greater in women with a history of recurrent gestational loss.

The purpose of this essay is to analyze and collect information to inform about the detection of chronic thyroiditis and how it can affect children and adults of all ages.

History of chronic thyroiditis

Chronic thyroiditis is constituted as the main cause of hypothyroidism the world discovered by DR. Hakaru Hashimoto in the year of 1912, he detected a lymphocyte infiltrate that I name as "lymphomatous struma" in patient thyroid.

Subsequently, in the year of 1956 Deborah Doniach and Ivan Roitty collaborate in the study of chronic thyroiditis to better understand the autoimmune base by building thyoglobulin as the antigen car that triggered an autoimmune process against the thyroid gland. Then a second autoantigen was found in the microsomal fraction, currently known as thyroid peroxidase.

At present for chronic thyroiditis its diagnosis is made a relationship of the size of the thyroid gland through palpation to determine different characteristics such as consistency, if this is firm or gumous, painless, if it has an irregular surface or by exams thatThey tell us if you have a functional failure due to the presence of high levels of blood antithyroid antibodies.

Chronic thyroiditis

Hashimoto chronic thyroiditis or thyroiditis as it is known contains the characteristic of being an autoimmune disease, this wants to say that it arises from the attack of the autoimmune system, in this case against the thyroid gland where an inflammation occurs.Damage of this condition in the thyroid gland therefore a decrease in thyroid hormone (hypothyroidism).

Hypothyroidism is “the clinical picture that derives from a small activity of the thyroid gland. Thyroid hormones (T4 and T3), whose synthesis is regulated by the TSH secreted in the pituitary gland, have as a fundamental mission regulate the metabolic reactions of the organism ”. 

Causes

The causes by which chronic thyroiditis is presented are varied and is not yet necessary to accurate. People with chronic hashimoto thyroiditis have antibodies with various types of thyroid antigens.

The causes can be presented as genetic risk factors to develop chronic thyroiditis, these can be the family of genes known as human leukocyte antigens (HLA), which are in charge of helping the immune system to distinguish the body’s own proteins andproteins produced by viruses and agents or other bacteria.

It has also been observed that this disease is much more common in people who have relatives who seem like this disease.

Non -genetic factors that can trigger the disease include changes in sex hormones (especially in women), viral infections, certain medications, high cholesterol, vitamin D deficiency, exposure to ionizing radiation or pesticides and excess iodine consumption (involved in the production of thyroid hormones). 

Symptoms

In chronic thyroiditis, patients are seen in the possibility of not presenting symptoms, but the common symptom is swelling of the front of the throat. Generally this condition advances very slowly over the years causing chronic thyroid damage, which causes low blood hormone levels.

Metabolism is affected in such a way that they present the following symptoms:

  • Fatigue and laziness
  • Greater cold sensitivity
  • Constipation
  • Pale and dry skin
  • Swollen face
  • Broken nails
  • Hair loss
  • Increased language size
  • Weight gain without apparent cause
  • Pain, sensitivity and muscle stiffness
  • Pain and stiffness of the joints
  • Muscular weakness
  • Excessive or prolonged menstrual bleeding (Menorrhagia)
  • Depression
  • Memory failures

Risk factor’s

Risk factors can determine a greater possibility of contracting this disease, these can be:

  • Sex: women are many more likely to develop chronic hashimoto thyroiditis between 10 to 15 times more to develop thyroiditis.
  • Age: Chronic thyroiditis can occur at any age, but above all it is frequent in middle -aged people.
  • Hereditary factor: This factor influences significantly because people with relatives who have thyroid diseases or other immune diseases are run a greater risk.
  • Other immune diseases: suffering from other immune diseases makes the risk of developing chronic thyroiditis.

Diagnosis

The initial diagnosis always begins with the examination of the front of the throat if an enlargement is found a blood test for its respective confirmation:

TSH exam: It is an exam that measures the amount of the stimulating hormone of the blood thyroid. This hormone is produced by the pituitary. Causes the thyroid gland to produce and secrete thyroid hormones in the blood.

T4 exam: T4 (thyroxine) is the main hormone produced by the thyroid gland. You can do a laboratory exam to measure the amount of free T4 in your blood.

T3 exam: triiodothyronin (T3) is a thyroid hormone. Play an important role in body control of metabolism (the many processes that control the rate of activity in cells and tissues).

Blood analysis to detect antiperoxidase antibodies. Most people with Hashimoto’s disease have these antibodies, but people with hypothyroidism caused by other conditions may not have them. Thyroid antiperoxidase antibodies can also be present in normal people without hypothyroidism. 

Treatment

"The treatment depends on the presence of hypothyroidism. In the absence of hypothyroidism, some doctors treat Hashimoto’s disease to reduce the size of the goiter. Others choose not to treat the disease and simply monitor their patients to evaluate the progression of the disease.

Anyway, with or without hypothyroidism, Hashimoto’s disease is treated with synthetic thyroid hormone. The used medication is called sodium levothyroxine and is administered orally, usually for life.

The exact dose of synthetic thyroid hormone depends on the age and weight of a person, the severity of hypothyroidism (if present), the presence of other health problems, and the use of other medications, such as medications to lower cholesterolthat could interfere with the action of synthetic thyroid hormone. The objective of treatment is to restore a normal thyroid state. The standard dose is 1.6 to 1.8 mcg / kg weight per day, but the dose is adjusted to the patient’s needs. Patients under 50 who have no heart problems are usually made of complete replacement dose. In patients over 50 years of age and in younger patients with heart disease, treatment with a low 25 mcg dose begins (0.025 mg) per day, with new evaluation after 6-8 weeks. " 

Importance of prevention

"When the diagnosis is not timely, gravity depends on how severe it is the degree of deterioration of thyroid function, so it is advisable to think about this gland, diagnosis and control in time to avoid future repercussions". 

The importance in the detection of thyroid diseases lies in avoiding long complications, in the case of hypothyroidism when it is not treated in time irreversible complications that affect the health of patients arise.

Conclusions

Given the information of this research we can reach the importance of caution and early treatment of thyroid diseases caused by chronic hashimoto thyroiditis being the most common cause for the development of hypothyroidism as we had mentioned above and how thisIt can affect physically as mentally, if people do not be careful to go on time even health professional, they can be very affected by this condition .

Bibliography

  • American Thyroid Association, ATA. (June 27, 2019). American Thyroid Association. Obtained from American Thyroid Association Web Site: https: // www.Thyroid.Org/thyroiditis-de-Hashimoto/
  • Clinic University of Navarra. (2020). Clinic University of Navarra. Obtained from Clinica University of Navarra Web Site: https: // www.cun.es/diseases-treatment/disease/hypothyroidism
  • Hannah-Shmouni, f. (SEPTEMBER of 2017). Hormone Health Network. Obtained from Hormone Health Network Web Site: https: // www.hormone.org/patients-and-dyes/disease-hayhimoto
  • Hormone Health Network. (September 1, 2017). Hormone Health Network. Obtained from Hormone Health Network Web Site: https: // www.hormone.org/patients-and-dyes/disease-hayhimoto
  • Majlis, s. (March 2, 2014). German clinic. Obtained from German clinic: https: // www.German clinic.CL/ARTICLES/Detail/2014/Hypothyroidism-in-Hombres-La-Importance-De-Consult
  • MAY CLINIC. (November 8, 2017). MAY CLINIC. Obtained from May Clinic Web: https: // www.Mayoclinic.Org/ES-ES/ESCOSES-CONTETIONS/HASHIMOTOS-DISEASE/SYMPTOMS-CAUSES/SYC-20351855
  • National Center for Advancing Translational Sciences. (17 of 10 of 2017). Genetic and Rare Diecese Information Center. Obtained from Genetic and Rare Diseases Information Center Web Site: https: // rarediseases.Info.nih.GOV/Espanol/12072/Del-Hayhimoto
  • Piraino N, P. S. (2010). Hashimoto chronic thyroiditis: clinical series. . Scielo, 827-831.  

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