Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2010 Dec 20;3(1):11.
doi: 10.1186/1756-6614-3-11.

Hashimoto thyroiditis is more frequent than expected when diagnosed by cytology which uncovers a pre-clinical state

Anca Staii  1 , Sarah Mirocha, Kristina Todorova-Koteva, Simone Glinberg, Juan C Jaume
Affiliations

Hashimoto thyroiditis is more frequent than expected when diagnosed by cytology which uncovers a pre-clinical state

Anca Staii et al. Thyroid Res. .

Abstract

Background: Our Thyroid-Multidisciplinary Clinic is a large referral site for thyroid diseases. Thyroid biopsies are mainly performed for thyroid cancer screening. Yet, Hashimoto thyroiditis (HT) is being too frequently diagnosed. The prevalence of HT is reported as 0.3-1.2% or twice the prevalence of type 1 diabetes. However, the prevalence of HT confirmed by cytology is still uncertain. To evaluate different aspects of thyroid physiopathology including prevalence of Hashimoto's, a database of clinical features, ultrasound images and cytology results of patients referred for FNA of thyroid nodules was prospectively developed.

Methods: We retrospectively studied 811 consecutive patients for whom ultrasound guided thyroid FNA biopsies were performed at our clinic over 2.5 year period (Mar/2006-Sep/2008).

Results: The analysis of our database revealed that from 761 patients, 102 (13.4%) had HT, from whom 56 (7.4%) were euthyroid or had sub-clinical (non-hypothyroid) disease, and 46 (6%) were clinically hypothyroid.

Conclusions: This is the first study to show such a high prevalence of HT diagnosed by ultrasound-guided FNA. More strikingly, the prevalence of euthyroid HT, appears to be >5% similar to that of type 2 diabetes. Based on our results, there might be a need to follow up on cytological Hashimoto's to monitor for thyroid failure, especially in high risk states, like pregnancy. The potential risk for thyroid cancer in patients with biopsy-proven inflammation of thyroid epithelium remains to be established prospectively. However, it may explain the increased risk for thyroid cancer observed in patients with elevated but within normal TSH.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Patients' allocation diagram.
Figure 2
Figure 2
Prevalence comparison. Chart comparison is provided between this study and NHANES III (9). The total population of NHANES III study is used as a reference for the comparison of clinical and subclinical disease in both studies.
Figure 3
Figure 3
A. Ultrasound image of euthyroid Hashimoto thyroiditis. A representative ultrasound is shown of an asymptomatic, euthyroid patient's thyroid nodule cytologically diagnosed Hashimoto thyroiditis. Note the minimal color flow Doppler identified within the nodule. B. Cytopathology. Cytological characteristics of a thyroid nodule with typical diagnostic features of Hashimoto's thyroiditis (i.e. lymphocytic infiltrate, Hurthle cells, lymphoglandular bodies and crushed lymphocytes).
See this image and copyright information in PMC

References

    1. Jaume JC. In: Greenspan's Basic & Clinical Endocrinology. Gardner DG, Shoback DM, editor. New York: McGraw-Hill Medical; 2007. Endocrine autoimmunity; pp. 59–79.
    1. Weetman AP. In: The Autoimmune Disease. Rose NR, Mackay IR, editor. Elsevier; 2006. Thyroid disease; pp. 467–482. full_text.
    1. Radetti G, Gottardi E, Bona G, Corrias A, Salardi S, Loche S. Study Group for Thyroid Diseases of the Italian Society for Pediatric Endocrinology and Diabetes (SIEDP/ISPED). The natural history of euthyroid Hashimoto's thyroiditis in children. J Pediatr. 2006;149:827–832. doi: 10.1016/j.jpeds.2006.08.045. - DOI - PubMed
    1. Surks MI, Ortiz E, Daniels GH, Sawin CT, Col NF, Cobin RH, Franklyn JA, Hershman JM, Burman KD, Denke MA, Gorman C, Cooper RS, Weissman NJ. Subclinical thyroid disease: scientific review and guidelines for diagnosis and management. JAMA. 2004;291:228–238. doi: 10.1001/jama.291.2.228. - DOI - PubMed
    1. Brent GA. Diagnosing thyroid dysfunction in pregnant women: is case finding enough? J Clin Endocrinol Metab. 2007;92:39–41. doi: 10.1210/jc.2006-2461. - DOI - PubMed

LinkOut - more resources