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Hashimoto Disease

Armand Krikorian, FACP, FACE, MD, MBA and Sylvia M Chlebek, Doctor of Osteopathic Medicine Reviewed 06/2022
 


BASICS

DESCRIPTION

  • Hashimoto thyroiditis (HT), also called lymphocytic thyroiditis or chronic autoimmune thyroiditis, is characterized by autoimmune destruction of the thyroid gland that can result in ...

DIAGNOSIS

HISTORY

  • Although asymptomatic in early stages, cases, most patients will present with symptoms specific for hypothyroidism:

    • Fatigue

    • Cold intolerance

    • Mild weight gain

    • Hoarse voice

    • Dry skin

    • Hair loss

    • ...

TREATMENT

GENERAL MEASURES

  • The goal of treatment is to alleviate symptoms and return serum TSH levels to the normal range.

  • Oral thyroid hormone replacement should be considered in all patients with over...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

  • TSH can be monitored every 4 to 6 weeks and dose titrated to achieve target goals.

  • Once target goal is achieved, then TSH should be monitored yea...

REFERENCES

1
Biondi B, Cappola AR, Cooper DS. Subclinical Hypothyroidism: A Review. JAMA. 2019;322(2):153-160.
2
Hollowell JG, Staehling NW, Flanders WD, et al. Serum TSH, T(4), and thyroid antibodies in...

CODES

ICD10

  • E06.3 Autoimmune thyroiditis

  • E03.9 Hypothyroidism, unspecified

  • E04.9 Nontoxic goiter, unspecified

SNOMED

  • 21983002 Hashimoto thyroiditis (disorder)

  • 40930008 Hypothyroidism (disorder)

  • 3716002 Goite...

CLINICAL PEARLS

  • HT progresses from asymptomatic to overt hypothyroidism. Thyroid hormone replacement is recommended for overt hypothyroidism and subclinical hypothyroidism with TSH >10 mU/L The bal...

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