HAIT of the thyroid gland - what is it and how dangerous is such a pathology? In fact, this disease is considered quite common, and almost anyone can be affected.
Chronic thyroid autoimmune thyroiditis (HAIT) is an inflammatory ailment triggered by autoimmune changes. The body, responding to certain processes, begins to produce antibodies to thyroid cells, which gradually leads to their destruction. Against the background of this condition, the production of thyroid hormones in the endocrine system slows down, as a result of which transient hypothyroidism appears.
HAIT of the thyroid gland - what is it
In a healthy person, immunity produces against pathogenic bacteria and viruses, but autoimmune reactions occur due to various functional abnormalities. The specific reasons for the development of such a process are still a mystery, however, doctors have revealed the relationship of this pathology with a genetic predisposition. Those with a family history of endocrine diseases are at greater risk of thyroid gland HAIT.
Why does it appear?
Such factors are capable of provoking the development of this ailment:
- infections of a viral and colds nature;
- caries;
- chronic forms of sinusitis, otitis media, tonsillitis;
- harmful environmental conditions;
- long-term therapy using iodine;
- diabetes;
- radioiodine therapy;
- radiation exposure;
- chronic systemic problems;
- excessive emotional shock.
Risk groups
There are several causes of diffuse changes in the thyroid gland according to the type of HAIT.
- Hormonal disruptions. This reason is most common. In this case, diffuse changes in the thyroid gland with HAIT occur as an increase. Moreover, this process can be a uniform and uneven change in an organ or its tissues.
- Iodine deficiency. This factor also affects the appearance of pathology. This often happens in certain places of residence, especially in endemic regions. Residents of such places are at high risk.
- Disturbed activity of the autoimmune system. Inflammation originates in the cells of the thyroid gland. This process is accompanied by deviations in the functioning of the immune system. In such a situation, it does not work correctly; it perceives the organ as alien. At the same time, antibodies attacking the thyroid gland are produced in the body. If the immune system works fine, this cannot happen.
- Unhealthy diet. Against the background of a constant lack in food of the required volume of iodine, the organ gradually changes. If a person eats certain foods for a long time, abnormal changes in the thyroid gland are noted. They act on the hormonal cells produced as a result. Excessive consumption of corn, soybeans, beans, turnips, cauliflower and white cabbage can contribute to the development of pathology.
HAIT of the thyroid gland is detected most often in women aged 40-50 years. As for men, they are exposed to this pathology about 10 times less often. This phenomenon is explained by the influence of estrogen on the female body and violations of the X chromosome. HAIT accounts for about 30% of all diseases of the endocrine system.
Clinical picture
HAIT of the thyroid gland is a disease that can be completely asymptomatic for a long period. Gradually, as the disease develops, the volume of the damaged organ can increase, which is accompanied by strong compression of the esophagus, blood vessels, trachea and nerve receptors.
The main sign of HAIT of the thyroid gland at this stage is an unpleasant sensation of the presence of a foreign object in the throat. It becomes difficult for a person to swallow, pain may be observed in the neck area with sudden turns of the head. Unpleasant sensations are greatly amplified at the time of palpation. In addition, people suffering from this disease often complain of general weakness, aching joints and muscles, and fatigue too fast.
At the initial stage of HAIT of the thyroid gland, thyrotoxicosis occurs, which is characterized by an increase in the volume of thyroid hormones in the body. This condition develops against the background of the release of the reserve T4 and T3 from damaged thyroid follicles.
Symptoms of thyrotoxicosis with HAIT are most often the following phenomena:
- loss of appetite;
- abnormal weight loss;
- vomiting and nausea;
- high blood pressure;
- swelling on the face;
- yellowing of the skin;
- excessive sweating;
- tachycardia;
- bulging eyes.
Leakage features
With HAIT, thyrotoxicosis has a passing character, and over time, hypothyroidism and euthyroid pathology appear instead. A similar phenomenon occurs against the background of the death of a large area of the thyroid gland - the process can take 5-15 years. Typical signs of deficiency of T4 and T3 are more pronounced with the influence of harmful factors: excessive fatigue, stress, period of exacerbation of chronic ailments.
With HAIT, the signs are as follows:
- low pressure;
- arrhythmia;
- depression, irritability;
- swelling on the face;
- tremor of the legs or arms;
- brittle nails, excessive hair loss;
- insulin resistance;
- abnormal weight gain, which is difficult to get rid of.
Classification
Due to the characteristics of the clinical picture, autoimmune pathology is conditionally divided into several types:
- With latent HAIT of the thyroid gland, the symptoms are practically absent. The organ itself has normal sizes or is slightly increased, the activity is not disturbed.
- The hypertrophic type of HAIT of the thyroid gland is accompanied by diffuse changes, covering the damaged organ, or the formation of nodes in its tissues. A combination of nodular and diffuse goiter is likely. With the hypertrophic form of HAIT, the work of the thyroid gland, as a rule, does not suffer. Very rarely, at the initial stage, thyrotoxicosis is detected, which eventually flows into hypothyroidism.
- The atrophic variety of HAIT does not provoke an enlargement of the thyroid gland. The clinical picture is characterized by signs of hypothyroidism. This variety is considered the most severe form of pathology, most often diagnosed in people of advanced age and young girls after radioiodine therapy.
HAIT course phases
The development of this pathology can be conditionally divided into several stages with typical symptoms:
- The euthyroid phase - the normal activity of the thyroid gland is preserved, the person has practically no signs of the disease, the general state of health remains the same.
- The subclinical stage is characterized by an increase in the production of thyroid-stimulating hormones by the pituitary gland. They, in turn, contribute to increased production of T4 and T3, so that the volume of thyroxine reaches normal levels.
- The thyrotoxic phase is characterized by typical symptoms of thyrotoxicosis. Many damaged thyroid follicles penetrate into the bloodstream, which continue to produce hormones. The immunity at the same time begins to produce an increased amount of antibodies, which exacerbates the course of HAIT.
- The hypothyroid stage occurs against a background of deficiency of T4 and T3. There are changes in the thyroid gland according to the type of HAIT, its activity slows down, the area of glandular tissue decreases. This phase can last a maximum of a year, after which the work of the affected organ stabilizes. Although in some cases this condition can persist for life.
HAIT is able to systematically flow from one form to another, or manifest only signs of hypothyroidism and thyrotoxicosis. The severity of the symptoms of pathology is determined by the age of the patient and the presence of concomitant ailments.
Diagnosis of HAIT
First of all, the endocrinologist examines and interrogates the patient, after which he palpates the thyroid gland and collects all the necessary history. During the study, an increase in the volume of the organ, its compaction, the formation of nodes, pain in the lower neck can be detected.
With the help of laboratory tests for the concentration of thyroid hormones, you can determine the stage of HAIT. With thyrotoxicosis, the level of T4 and T3 will be significantly increased, and TSH remains in normal quantities. The hypothyroid phase occurs with a reduced concentration of thyroxine, as well as an increased or normal level of thyroid-stimulating hormone.
ELISA examination reveals antibodies to thyroproxidase, colloidal antigens, thyroglobulin, thyroid tissue. The results of a general blood test show an increased number of lymphocytes and a low concentration of white blood cells.
Diagnosis
Ultrasound is performed to determine the general condition and size of the thyroid gland. If it has seals, a fine-needle aspiration biopsy is performed, which is needed to study the tissues of the node and detect tumor cells.
The diagnosis can be confirmed after the detection of antibodies to ATPO, signs of hypothyroidism, as well as the detection of hypoechogenicity of the thyroid gland.
In addition, differential diagnosis of an autoimmune pathology of Riedel goiter, nodular goiter, organ cancer and de Querven thyroiditis is required.
Treatment of HAIT of the thyroid gland
Specific therapy is necessary only at the thyrotoxic and hypothyroid stage of the disease. Indeed, with the subclinical and euthyroid phase, the thyroid gland remains normal, a person does not feel any discomfort.
With an increased concentration of thyroid hormones, the patient is not prescribed thyreostatics that inhibit the excessive production of T4 and T3, since the initial cause of the problem is definitely not in hyperthyroidism. Hypotheriosis is treated with thyroxine analogues. The most commonly prescribed drugs are L-thyroxine and Levothyroxine. Hormone therapy is carried out exclusively under the supervision of an endocrinologist. In this case, it is very important to systematically examine the blood for hormone levels. A suitable dosage is selected individually, depending on the age of the patient, his weight, general well-being, as well as the presence of defects of the cardiovascular system.
Therapy Features
To reduce the number of antibodies, doctors usually prescribe adaptogens and immunosuppressants. Non-steroidal anti-inflammatory drugs like Nise, Diclofenac, and Nurofen can help reduce pain and reduce inflammation. If HAIT proceeds in parallel with subacute thyroiditis, glucocorticoids - "Dexamethasone" and "Prednisolone" are used. If the activity of other organs and systems is impaired, symptomatic treatment is performed.
If the thyroid gland enlarges too quickly, exerting pressure on nearby structures, is abnormally located or is characterized by too many large nodes, a surgical procedure is prescribed for the patient, which involves partial or complete removal of the damaged organ.
Further forecast
HAIT of the thyroid gland is usually characterized by a progressive course. Given the timely implementation of maintenance therapy, restoration of hormonal balance and compliance with all the instructions of the endocrinologist, approximately 85% of all cases achieve a positive result and a long stage of remission.
The performance of people suffering from subclinical HAIT is maintained for at least 20 years after the onset of the disease. If the patient does not receive full treatment, a persistent form of hypothyroidism occurs, deviations in the activity of the cardiovascular system and digestive tract are observed, and diabetes mellitus appears.