Along with diseases of the cardiovascular system, the growth of endocrine disorders — diabetes mellitus and thyroid lesions of a different nature — is also progressing.
Among the latter, hypothyroidism occupies a special place, since its appearance in childhood causes a severe lack of mental and physical development of the child. Most often, this is the so-called
autoimmune thyroiditis, or Hashimoto's goiter. In this case, the disease can occur in three clinical forms. This is hypertrophic, in which compensatory
thyroid hyperplasia occurs
, atrophic, developing in the second stage of the disease and characterized by the replacement of the normal structure with connective tissue, and focal, in which the lesion covers only one lobe of the organ.
Analysis value
Often, the only accurate evidence of the disease is the detection of anti-TPO in the blood, that is, antibodies to thyroperoxidase , the main enzyme for the formation of triiodothyronine and thyroxine.
Due to their activity, the iodination of thyroglobulin, a structural protein of the thyroid gland, is disrupted, which blocks the further stages of the synthesis of its hormones. Since this is the most sensitive test in the diagnosis of Hashimoto's goiter, when a doctor suspects this disease, a hormonal blood test is prescribed. In case of a positive result, anti-TPO will be elevated, and then the diagnosis will be fully proved. Only in this case will the doctor receive the right to recommend adequate therapy and provide a favorable prognosis for the patient. This test is especially important for pregnant women, because if they show anti-TPO, this indicates a serious risk of developing postpartum thyroiditis and the harmful effects of pathology on the fetus. The level of these antibodies is normally 0-5.6 IU per ml of blood serum, and its decrease can be observed in healthy people under the age of 50 years. But the test may turn out to be positive (anti-TPO above the norm) for other thyroid diseases, so the diagnosis of such pathologies should be carried out necessarily comprehensively, together with analysis for T3, T4 and TSH.
Comprehensive study
Hashimoto's disease occurs when a malfunction occurs in the human immune system, namely with its hyperreaction or a decrease in T-suppressor activity. Therefore (along with anti-TPO), other antibodies are found in the blood of patients: both the structure of the thyroid gland (to thyroglobulin of the microsomal fraction) and completely different organs. This determines its combination with other, non-endocrine, pathologies of autoimmune genesis. In addition to tests for anti-TPO and hormones, instrumental confirmation of Hashimoto's goiter is needed. So, with an
ultrasound examination of the thyroid gland , heterogeneity of its structure, hypoechoic effects of some areas, the presence of calcifications and thickening of the capsule can be detected. The prognosis of the disease becomes more severe in cases where nodes appear in the organ, since in about 5% of cases they become malignant.