Autimmune thyroiditis (AIT). Fighting autoimmune diseases of the thyroid gland Chronic autoimmune thyroidity diagnostics

17.09.2020 Diet

An autoimmune thyroiditis is a pathology, which is mainly susceptible to the elderly women (45-60 years). Characterized by pathology developing strong inflammatory process in area thyroid gland. Arises due to serious failures in functioning immune systemAs a result, it begins to destroy the cells of the pin.

The susceptibility of pathology is precisely the elderly women due to X-chromosomal impaired and the negative effect of estrogen hormones on cells forming a lymphoid system. Sometimes the disease can develop, both in young people and young children. In some cases, pathology is also found in pregnant women.

What could cause AIT, and is it possible to recognize it yourself? Let's try to figure it out.

What it is?

An autoimmune thyroiditis is inflammation flowing in the tissues of the thyroid gland, the main cause of which is a serious failure in the immune system. On his background, the body begins to produce anomalous large amount of antibodies that gradually destroy healthy thyroid cells. Pathology develops in women almost 8 times more often than men.

Causes of AIT development

Thyroidita Hashimoto (pathology received its name in honor of the doctor who was the first to describe its symptoms) develops for a number of reasons. A primary role in this matter is given:

regular stressful situations;
emotional overvoltage;
an excess of iodine in the body;
unfavorable heredity;
the presence of endocrine diseases;
uncontrolled reception;
negative impact of the external environment (it may be bad ecology and many other similar factors);
irregular nutrition, etc.

However, do not panic - autimmune thyroiditis - This is a reversible pathological process, and the patient has every chance to establish the work of the thyroid gland. To do this, it is necessary to ensure the reduction of loads on its cells, which will help reduce the level of antibodies in the patient's blood. For this reason, timely diagnosis of the disease is very important.

Classification

An autoimmune thyroiditis has its own classification according to which it happens:

Barely, the causes of the development of which were completely installed to the end.
Postpartum. During the pregnancy, the immunities of women weakens significantly, and after the birth of the baby, on the contrary, it is activated. Moreover, its activation is sometimes anomalous, since it begins to produce an excessive amount of antibodies. Often, the consequence of this is the destruction of the "native" cells of various organs and systems. If a woman has a genetic predisposition to Ait, it needs to be extremely attentive, and carefully monitor the state of his health after delivery.
Chronic. In this case, we are talking about genetic predisposition to the development of the disease. It is preceded by a decrease in the production of hormones of organisms. This condition is called primary.
Cytokine-induced. This thyroiditis is a consequence of administration of drugs based on interferon, used in the treatment of hematogenous diseases and.

All types of AIT, besides the first, manifest themselves among the same symptoms. The initial stage of the development of the disease is characterized by the occurrence of thyrotoxicosis, which, in untimely diagnosis and treatment, can go into hypothyroidism.

Development Stages

If the disease was not detected in a timely manner, or for any reason, it was not treated, it could cause progression for its progression. Stage AIT depends on how long it developed. Hashimoto disease is divided into 4 stages.

Eutherioid phase. Each patient has its duration. Sometimes it may be enough for several months to translate the disease to the second stage of development, in the other cases between phases may pass for several years. Throughout this period, the patient does not notice special changes in his well-being, and does not appeal to the doctor. The secretory function is not broken.
In the second, subclinical, stage of T-lymphocytes, the follicular cells are actively attacking, leading to their destruction. As a result, the body begins to produce a significantly less hormone hormone. T4. Eutherios remains due to a sharp increase in the level of TSH.
The third phase is thyrotoxic. It is characterized by a strong jump of hormones T3 and T4, which is explained by their release from the destroyed follicular cells. Their entering blood becomes powerful stress for the body, as a result of which the immune system begins to rapidly produce antibodies. When falling the level of functioning cells, hypothyroidism is developed.
The fourth stage is hypothyroid. The functions of the thyroid gland can recover themselves, but not in all cases. It depends on what form proceeds in what form. For example, chronic hypothyroidism can flow for quite a long time, turning into an active stage that replaces the phase of remission.

The disease may be both in the same phase and pass all the above stages. It is extremely difficult to predict exactly how the pathology proceeds.

Symptoms of autoimmune thyroiditis

Each forms of the disease has its own features of manifestation. Since the ait does not represent a serious danger to the body, and its final phase is characterized by the development of hypothyroidism, nor the first, but the second stage is no clinical signs Dont Have. That is, the symptoms of pathology is essentially combined from those anomalies that are characteristic of hypothyroidism.

Let us list the symptoms characteristic of the autoimmune thyroidity of the thyroid gland:

periodic or constant depressive state (purely individual sign);
worsening memory;
problems with concentration of attention;
apathy;
constant drowsiness or feeling of fatigue;
sharp weight leaving, or gradual increase in body weight;
deterioration or complete loss of appetite;
slow pulse;
headiness of the hands and legs;
dilution of forces even with full nutrition;
difficulties with the implementation of ordinary physical work;
the ability of the reaction in response to the impact of various external stimuli;
sweating of hair, their fragility;
dryness, irritation and peeling of the epidermis;
constipation;
reducing sexual attraction, or its full loss;
violation menstrual cycle (development of intermented bleeding, or complete cessation of menstruation);
female swelling;
the yellowness of the skin;
problems with faith and others.

At postpartum, silent (asymptomatic) and cytokine-induced AIT characterized alternation of the phases of the inflammatory process. With the thyrotoxic stage of the disease, the manifestation of the clinical picture is due to:

sharp weight loss;
heat feelings;
increasing the intensity of sweating;
poor well-being in stuffy or small rooms;
tremors in fingers;
sharp changes in the psycho-emotional state of the patient;
cardiac rhythm;
attacks;
worsening attention and memory;
loss or reduction of libido;
fast fatigue;
general weakness, to get rid of which even a full-fledged rest helps;
sudden attacks of increased activity;
problems with menstrual cycle.

The hypothyroid stage is accompanied by the same symptoms as chronic. For postpartum Aita, the manifestation of thyrotoxicosis symptoms in the middle of 4 months is characterized in the middle of 4 months, and the detection of symptoms of hypothyroidism at the end of 5 - at the beginning of 6 months of the postpartum period.

In case of nonsense and cytokine-induced AIT, special clinical signs are not observed. If there is an ailment, still, they are manifested, they have an extremely low degree of severity. With asymptomatic flow, they are detected only during a preventive examination in a medical institution.

What the autoimmune thyroidite looks like: photo

The photo below shows how the disease occurs in women:

Diagnostics

Before the emergence of the first alarming signs of pathology, it is almost impossible to identify its availability. In the absence of unreasoning the patient, it does not consider it appropriate to contact the hospital, but even if it does it, it will be almost impossible to identify pathology using tests. However, when the first adverse changes in the work of the thyroid gland will begin to occur, clinical study The biological sample will immediately reveal them.

If other family members suffer or have previously suffered from such disorders, it means that you are in the risk group. In this case, attend a doctor and undergo preventive studies need as often as possible.

Laboratory studies in suspected AIT include:

general blood analysis, with which the level of lymphocytes is installed;
tests for hormones required for measuring TSH in blood serum;
immunograms, which establishes the presence and antibodies to AT-TG, thyroperoxidase, as well as thyroid hormones;
a thin game biopsy necessary to establish the size of lymphocytes or other cells (their increases indicates the presence of autoimmune thyroiditis);
Ultrasound diagnostics of the thyroid gland helps to establish its increase or decrease in size; When Ait, a change in the structure of the SCS is occurring, which can also be detected during the ultrasound.

If results ultrasonic research Indicate the AIT, but the clinical tests refute its development, the diagnosis is considered doubtful, and the patient does not fit into the history of the patient.

What will happen if not treated?

Thyroiditis can have unpleasant consequences that differ for each stage of the disease. For example, with a hyperthyroid stage, the patient can break heartbeat (arrhythmia), or heart failure arise, and this is already fraught with the development of such dangerous pathology as myocardial infarction.

Hypothyroidism can lead to the following complications:

dementia;
infertility;
premature interrupt pregnancy;
impossibility to carry out fruit;
congenital hypothyroidism in children;
deep and protracted depressions;
myxedema.

With a myxedema, a person becomes hypersensitive to any temperature changes in a smaller side. Even banal flu, or other infectiontransferred under a given pathological condition may cause a hypothyroid coma.

However, it is not necessary to worry much - such a deviation is a reversible process, and is easily treatable. If you correctly choose the dosage of the drug (it is prescribed depending on the level of hormones and at-TPOs), then the disease during a long period of time may not remind themselves.

Treatment of autoimmune thyroiditis

Ait treatment is carried out only at the last stage of its development - at. However, in this case, certain nuances are taken into account.

Thus, therapy is carried out exclusively with manifestic hypothyroidism, when the TSTG level is less than 10 honey / l, and CV. T4 reduced. If the patient suffers from the subclinical form of pathology with TSH in 4-10 honey / 1 l and with normal indicators sv. T4, then, in this case, treatment is carried out only with the symptoms of hypothyroidism, as well as during pregnancy.

Today, the most effective in the treatment of hypothyroidism are drug-based drugs based on levothyroxine. A feature of such drugs is that their active substance is as close as possible to human hormone T4. Such means are absolutely harmless, so they are allowed to be taken even during pregnancy and GW. Preparations practically do not cause side Effects, and, despite the fact that they are based on a hormonal element, they do not lead to an increase in body weight.

Levothyroxin-based drugs should be taken "isolated" from other drugs, since they are extremely sensitive to any "outsiders" substances. The reception is carried out on an empty stomach (half an hour before the meal or the use of other drugs) with the use of an abundant amount of fluid.

Calcium, multivitamins, iron-containing drugs, sucralfat, etc., should be taken no earlier than 4 hours after receiving Levothyroxine. SAME effective means On its basis are L-thyroxine and euticox.

Today there are a lot of analogues of these drugs, but it is better to give preference to the originals. The fact is that it is they who have the most positive effect on the patient's body, while analogs can only bring the temporary improvement in the patient's health.

If from time to time you go from the originals for generics, then you must remember that in this case the dosage correction will need active substance - Levothyroxine. For this reason, every 2-3 months it is necessary to take blood test to determine the level of TSH.

Nutrition at AIT

Treatment of the disease (or a significant slowdown in its progression) will give higher results if the patient avoid food causing thyroid gland. In this case, it is necessary to minimize the frequency of consumption of products containing gluten. Under the ban hit:

cereal cultures;
flour dishes;
bakery products;
chocolate;
sweets;
fast food, etc.

At the same time, you need to try to eat products enriched with iodine. They are especially useful when dealing with the hypothyoid form of autoimmune thyroiditis.

When AIT, it is necessary to take a serious seriousness to the issue of protecting the body from the penetration of pathogenic microflora. You should also try to clean it from pathogenic bacteria that are already in it. First of all, you need to take care of the cleansing of the intestine, because it is actively reproduction that harmful microorganisms. To do this, in the diet of the patient should include:

fermented milk products;
coconut oil;
fresh fruits and vegetables;
low-fat meat and meat broths;
different types of fish;
sea cabbage and other algae;
dust crested.

All products from the above list contribute to the strengthening of the immune system, enrich the body with vitamins and minerals, which, in turn, improves the functioning of the thyroid gland and intestines.

Important! If a hyperthyroid form of ait occurs, it is necessary to completely eliminate all products from the diet, which contains iodine, since this element stimulates the production of T3 and T4 hormones.

When ait is important to give preference to the following substances:

selenium, which is important in hypothyroidism, as it improves the secretion of hormones T3 and T4;
vitamins of a group in promoting the improvement of metabolic processes and help maintain the body in a tone;
probiotics, important to maintain the intestinal microflora and prevent dysbacteriosis;
plant adaptogens, stimulating the production of hormones T3 and T4 with hypothyroidism (Rhodiola pink, Rush Mushroom, Root and Ginseng Fruits).

Forecast treatment

What is the worst way to expect? The prognosis of the AIT treatment, as a whole, is quite favorable. If there is a persistent hypothyroidism, the patient will have to take drugs based on levothyroxine until the end of the life.

It is very important to monitor the level of hormones in the patient's body, so once every six months it is necessary to pass a clinical analysis of blood and ultrasound. If during an ultrasound study, a noded seal in the scope of the scope will be seal, this should be a good reason for passing consultation from the endocrinologist.

If an increase in the nodules was observed during the ultrasound, or their intensive growth was observed, the patient appoints a puncture biopsy. The resulting tissue pattern is examined in the laboratory in order to confirm either refute the presence of a carcinogenic process. In this case, ultrasound is recommended once every six months. If the node does not have tendency to zoom, the ultrasound diagnostics can be performed once a year.

The mechanism of autoimmune reactions in the thyroid gland may differ. With autoimmune thyroid, the antibodies damage thyroidocytes, the destroyed follicles replaces the connecting tissue, which leads to hypothyroidism. In the diffuse toxic zob, the antibodies activate the TSR receptors of thyroidocytes, which leads to hyperfunction of the thyroid gland and thyrotoxicosis. However, with diffuse toxic goiter and autoimmune thyroid in the tissue of the thyroid gland, similar changes are determined - lymphoid infiltration and proliferation of the connective tissue.

The main ultrasound signs of the autoimmune process in the thyroid gland are reduced echogenicity of parenchyma and linear hyperheogenic inclusions. The basis of reduced echogenicity is the high cell due to lymphoid infiltration - in sharply hypochogenic focus, inflammation is maximally expressed. In hyperechogenic structures, a parenchyma on the connecting tissue occurred. The results of the ultrasound should be assessed in conjunction with common state and a hormonal patient profile.

Thyroid echostructure with autoimmune inflammation

a little changed fabric - against the background of normal parenchyma, hypo echogenic inclusions (2-4 mm) are determined with clear contours without "halo";
a modified fabric - on the background of parenchyma reduced echogenicity, hypo echogenic inclusions (4-6 mm) with clear contours without "halo" are determined;
a sharply modified fabric - against the background of a general decrease in echogenicity, almost aehogenic foci and hyperheogenic structures of various sizes and shape are determined.

Autimmune thyroiditis (AIT) on ultrasound

Ait confirms positive anti-ramp antibodies - to thyroperoxidase (at-TPO) and thyroglobulin (AT-TG). The functional state of the gland may be different - hyper-, hypo-or eutheosis.

Distinguish hypertrophic and atrophic Forms AIT. With hypertrophic form, the volume of the gland is significantly increased. In atrophic form, the volume of the gland is reduced or within the normal range, often accompanies hypothyroidism. These forms of development options or sequential stages of AIT are an open question.

Press on the pictures to enlarge.

Picture. Patomorphology AIT: diffuse (sometimes focal) infiltration of gland lymphocyte and the formation of lymphoid follicles with reproduction centers; The main membrane and the epithelial wall of the follicles are damaged, and the amount of colloid is reduced or it is missing; Plots of fibrosis. In atrophic form, the Ait is most of the parenchyma substituted connective tissue.

Picture. Patient with eutheyosis and anti-rapid antibodies. On ultrasound thyroid iron normal sizes; In the rear-lower departments of both fractions, hypo echogenic sections with a fuzzy contour (arrow) are determined; Bloodstock in the abnormal zone is reinforced. Conclusion:Ait Local.

Picture. A girl of 10 years with eutheyosis and anti-rapid antibodies. On ultrasound, the thyroid gland is increased by 1.5 times - 13 ml (standard up to 8.3 ml). Against the background of unchanged parenchyma, hypo echogenic "snakes" are determined (lymphoid infiltration in the course of vessels). Bleeding is noticeably strengthened. Conclusion: Ait, hypertrophic form. Similarly, the diffuse toxic goiter.

Picture. Patient with hypothyroidism and anti-rapid antibodies. On ultrasound, the thyroid gland is diffusely increased; circuit wavy; Against the background of normal parenchyma in a large number of hypo echogenic foci (3-5 mm) with a clear contour without "halo". Conclusion: Ait, hypertrophic form.

Picture. Patient with hypothyroidism and anti-rapid antibodies. On ultrasound, the thyroid gland is diffusely increased; circuit buggy; Against the background of a general reduction in echogenicity, almost achogeneic zones are determined with a blurred contour, of various sizes and shapes. Conclusion: Ait, hypertrophic form.

Picture. Patient with hypothyroidism and anti-rapid antibodies. On ultrasound, the thyroid gland is diffusely increased; Echogenicity of Parenhim is sharply reduced, inhomogeneous. On the transverse cut, the entire volume of the right share occupy two rounded education. On the longitudinal cut, it can be seen that a contrasting connective tissue septum creates the illusion of the tumor. Conclusion: Ait, hypertrophic form.

Picture. Patient with hyperthyroidism and anti-rapid antibodies. On ultrasound, the thyroid gland is diffusely increased; Against a total reduction in echogenicity, hypo echogenic inclusions (2-4 mm) and linear hyperheogenic structures are determined; Bleeding is noticeably strengthened. Conclusion: Ait, hypertrophic form.

Picture. Patient with hypothyroidism and anti-rapid antibodies. On ultrasound, the thyroid gland is diffusely increased; Inhomogeneous - hypo echogenic areas are closed in hyperheogenic "honeycombs". Conclusion: Ait, hypertrophic form.

Picture. A man of 48 years with hypothyroidism and anti-rapid antibodies. On the ultrasound in dynamics, the thyroid gland decreases; inhomogeneous - small (2 mm) hypo echogenic inclusions are mixed with hyperhehogenic linear structures; Bleeding is noticeably strengthened. Conclusion: Ait, atrophic form.

Picture. Patient with hypothyroidism and anti-rapid antibodies. On the ultrasound in dynamics, the size of the thyroid gland is reduced; Parenchima sharply inhomogeneous - foci of reduced echogenicity (2-4 mm) are surrounded by hyperheogenic structures; Bleeding is noticeably strengthened. Conclusion: Ait, atrophic form.

At AIT, the risk of developing malignant tumors is increased. Small hyperheogenic foci are more likely benign. Large (more than 15 mm) Hypoheochogenic foci with uneven contours and calcifications suspicious on papillary carcinoma.Benign and malignant nodules can coexist.

Picture. Woman 33 years old with hypothyroidism and anti-rapid antibodies. On ultrasound, the thyroid gland is diffusively increased. Parenchima is heterogeneous due to the set of hyperheogenic foci (3-6 mm) with clear contours, without "halo"; Bloodstock in hypo echogenic areas is noticeably reinforced. Conclusion: Ait, hypertrophic form. This picture is very typical for AIT, so there is no need for biopsy. Hypoheochogenic linear structures are lymphoid infiltration. Regarding hyperheogenic pseudo-nodes, opinions were divided: unchanged parenchyma or fibrosis foci. Who knows exactly, write.

Picture. Patients with hypothyroidism and anti-rapid antibodies. On ultrasound, the thyroid gland diffusely increased, hypo echogenic, heterogeneous. In the first case, small hyperehogenic foci are typical pseudo-jels at AIT. In the second case, a hyperheogenic focus (more than 10 mm) with a non-uniform rim "halo" and point hyperhehogenic inclusions without acoustic shadows (psammomy taurus) is a papillary carcinoma.

Picture. The diffuse sclerosing version of the papillary cancer of the thyroid gland imitates thyroiditis. It is found primarily in young women, anti-rapid antibodies are often increased, can proceed with hypo-, hyper and eutheyosis. Diffuse infiltrating growth, fibrosis sites and many psammomomous calves are characterized. Metastases in regional lymph nodes Neck (arrow) are found in 75-100% of cases.

Diffuse toxic goiter (DTZ) on ultrasound

Ultrasonic signs of DTZ are close to hypertrophic form of ait. The normal size of the gland can only be at the beginning of the disease, then it increases dramatically and signs of thyrotoxicosis appear. There are two options: in an unchanged parenchyma, hypo echogenic "holes" or echogenicity is diffusely lowered. Against the background of hyperochogenic sites, thin hyperheogenic structures are noticeable - interdollastic partitions. They clearly appear due to a significant difference in the acoustic properties, and the true fibrotization is rare. When DTZ, blood flow is enhanced by extremely "flaming" iron. PSV on the upper and lower thyroid arteries is always above 40 cm / s.

With the beginning of the treatment of DTZ undergoes reverse development - the volume of the gland is gradually reduced, echogenicity increases, and the degree of heterogeneity decreases. When Ait anomalous ultrasound painting is maintained throughout the patient's life.

Picture. DTZ Patomorphology: Huge follicles, the active proliferation of the epithelium with the advent of the papillae gives the follicles of a star view; Colloid vacuolazed and stained by dyes; In stroma, lymphoid infiltration with the formation of lymphoid follicles.

Picture. Pronounced blood flow at DTZ (1) and hypertrophic form AIT (2). Note, when DTZ, hyperehogenic structures - foci of fibrosis are not expressed, unlike Ait.

Picture. In a patient with thyrotoxicosis on ultrasound, thyroid gland is increased, the contour of the wavy, the parenchyma is moderately hypochogenic, the echoostructure is inhomogeneous, the bloodstream is noticeably reinforced - "blazing iron". Conclusion: DTZ.

Picture. In patients with thyrotoxicosis on ultrasound, thyroid gland diffusely increased, hypo echogenic, inhomogeneous; In the right share, a hypo echogenic focus is determined (more than 10 mm) with a hyperheogenic non-uniform capsule, intra-transmodarial point hyperheogenic inclusions (psammomous tales). Conclusion According to the results of the biopsy: Papillary carcinoma amid DTZ.

Chronic fibrosis thyroiditis ridel on ultrasound

Tyareitis Ridel is a rare inflammatory disease of the thyroid gland. Parenchima is gradually replaced by a fibrous connective tissue and becomes solid as a stone. The fibrous fabric penetrates the skeletal muscles of the neck, spreads to the wall of the esophagus and the trachea, infiltrating and gradually blooding them. The function of the gland does not suffer for a long time, but the total fibrosis develops hypothyroidism.

It was not confirmed to assume that fibrous thyroiditis is the final stage of the AIT, since anti-random antibodies are not detected or available in low credits. The frequent combination of this thyroiditis with mediastinal, retrobulbar or retroperitoneal fibrosis allows it to attribute it to visceral fibromatosam.

Under Zobe Ridel on ultrasound, thyroid gland diffusely increased, hypo echogenic, the contour is poorly traced; Parenchima is heterogeneous at the expense of focus of fibrosis, colloid nodes can be present with a powerful capsule.

Picture. Patomorphology of fibrosing thyroiditis Riedela: the growth of fibrous connective tissue, among which the islands of atrophied and deprived of the lumen of follicles, separate lymphoid clusters with an admixture of eosinophils.

Picture. Women 46 years old with complaints about painless rocky density Education in the neck area, swallowing and hoarse voice. On ultrasound, the thyroid gland diffusely increased, hypo echogenic, heterogeneous due to hyperheogenic connective tissue structures; Sleepy artery is surrounded by a parenchy thyroid gland; lymphadenopathy cervical lymph nodes. Conclusion: FIBROZING TREARODITE RIDEAL.

Picture. The fibrosis thyroiditis Ridel on CT.

Subacute thyroidit de cervna on ultrasound

Subacute thyroidit de cerven - ungunny inflammation of the thyroid gland after transferred viral infection (influenza, cortex, vapotitis, etc.). Against the background of the temperature in the lower neck, painful swelling is determined. At the beginning of the disease, the inflammatory process is localized in one share, then captures the entire gland - "crawling thyroiditis." Initially, thyrotoxicosis appears, and then hypothyroidism. Common autoimmune reactions may be observed. A few weeks later, the subacute thyroiditis is resolved spontaneously, usually without disorders of the function of the thyroid gland. Non-steroidal anti-inflammatory drugs and corticosteroids can often stop the state in 24 hours.

With thyroid de cervane, the thyroid gland is diffuse or locally increased; In the region of the greatest pain, large hypooehogenic areas of irregular shape with blurred boundaries are determined (reduction in echogenicity in the center of "spots"), the bloodstream in the abnormal zone is almost absent; Regional lymph nodes are often increased. The presence of hyperheogenic structures is not typical. In the process of scarring, the damaged tissue can be replaced by fibrous, but in most cases the normal structure of the gland is restored.

Picture. Patomorphology of subacute thyroidita de Kervena: The inflammation site is infiltrated with lymphocytes and macrophages; After the destruction of the follicles is released colloid, the remains of which are surrounded by clusters of active macrophages and giant multi-core cells. Gigantic multi-core cells are formed when the macrophages are configured.

Picture. Elderly woman With complaints on temperature lifts and painful swelling at the bottom of the neck. On the ultrasound, the thyroid gland is increased, a large hypo echogenic zone of incorrect shape is determined, with blurred borders, without blood flow. With dynamic observation, the focus increased in size, as well as hypo echogenic areas appeared in the left. Conclusion: The subacute thyroidit de cervna.

Picture. A woman of 43 years old with a painful and dense "tumor" at the bottom of the neck. On ultrasound, the thyroid gland diffusely increased, the circuit of the wavy, hypooehogenic zones of the wrong shape, without clear boundaries, the blood flow on hypo echogenic areas is lowered. Conclusion: The subacute thyroidit de cervna. After 1 year (below), the thyroid gland decreased, the parenchyma of normal echogenicity, uniform.

Picture. On the ultrasound of the thyroid gland in the field of maximum pain, a large hypo echogenic portion of irregular shape is determined, without clear boundaries, there is no blood flow in the abnormal zone. The cervical lymph nodes are increased, hypo echogenic, rounded. Conclusion: The subacute thyroidit de cervna. With such an ultrasonic picture is needed differential diagnosis with carcinoma of the thyroid gland.

Take care of yourself, Your diagnostic!

Hatch (chronic autoimmune thyroiditis) - an inflammatory process of autoimmune thyroid gland, where those generated in human organism Lymphocytes damage the cells of the thyroid. The disease is considered one of the most common in endocrinology.

There is a given disease in people aged 40-50 years. However, people are in young age and even children recently suffer. The main reasons affecting the occurrence of the disease are not detected.

Hormones that produce thyroid gland are very important for the entire human body, as they control all metabolic processes: support body temperature, heart rate and perform other important functions. The violation in the functioning of the work of the thyroid gland entails the development of many consequences, negatively affects human health.

Chronic thyroidity of the thyroid gland develops quite slowly and gradually, causing devastating processes in the thyroid gland. Another name of this pathology is Tareloit Hashimoto - since it was the Japanese surgeon of Hashimoto for the first time, changes in the thyroid gland of an autoimmune character, which attack the cells of the organ itself.

Depending on the symptoms arising, the severity of the disease, the peculiarities of the flow and sizes of the thyroid gland, chronic autoimmune thyroiditis is divided into two forms:

Atrophic. This form is a fairly common case, patients who have or having dealing with radiation are particularly susceptible to it. The increase in the volume of the thyroid gland is not observed.
Hypertrophic. There is always an increase in the organ in size evenly or nodes.

Quite often on initial stage The development of the disease, the lymphomatous thyroiditis proceeds asymptomatic and clinically no manifestation. As the inflammatory process develops in the thyroid gland, the symptoms begin to appear. One of the first things is the unpleasant feeling in the area of \u200b\u200bthe throat, discomfort, as if something presses, is worth the com, there are difficulties with swallowing saliva. When palpation of the thyroid gland often occurs painfulness. In addition, during an inspection, the doctor may notice a change in the size of the gland, its structure (it can become more dense and druck).

The first most common feature of Hat is the presence of multiple antibodies in the laboratory blood test.

Over time, symptoms will manifest itself depending on the form in which the disease occurs:

In the atrophic form of the disease, symptoms is a hearing impairment, a state of passivity, drowsiness, lethargy. There is constant weakness, indisposition, reduction in ability to work. Skin covers become dry.
With hypertrophic form, such symptoms appear as an increase in the thyroid gland, the thyroid gland becomes dense and movable. Also obstacle, wheezes in the throat. Regular pains occur in the cervical department.

Later stage development stages, with a large emission of hormones in blood and damage to the thyroid cells, may be accompanied by symptoms of hyperthyroidism:

sharp weight loss;
breathing and speech activities;
reduction of visibility;
frequent headaches;
noise in ears;
bad state of health;
hyperthermia;
trembling fingers;
heart palpitations;
high blood pressure;
muscle cramps;
painness in the joints.

Hatch is manifested when the changes of the thyroid gland affected its operation. Signs of hyperthyroidism - an additional signal of the onset of the disease.

The reasons

According to medical statistics, chronic thyroiditis is much more often observed among female representatives. It is related, first of all, with frequent disorders in a hormonal background due to pregnancy and childbirth.

Allocate the following general reasons and factors affecting the development of the thyroid disease:

An earliest role is played by hereditary predisposition. If any of some of the relatives were various diseases endocrine system, including diabetesIt is worth considering this fact.
Long continuous uncontrolled intake of iodine-containing and hormonal drugs.
Radiation impact. It may arise as the result of a medical course, or a consequence of an environmental factor.
Imminent immunity frequent colds, The presence of chronic diseases.
Iodine deficiency in the body.
Operational interventions or injury.
Frequent stressful situations and constant high nervous overvoltage.

Diagnostics

For accurate diagnosis, a diagnostic examination is required.

First of all, the doctor's inspection with the study of the history and clinical manifestations.
Delivery of laboratory blood tests to determine the number of lymphocytes, antibody content and hormone levels.
Ultrasonic study (ultrasound) of the thyroid gland, namely its size, changes in the structure.
Biopsy - study of the material of the tissue of the thyroid gland.

Basic methods of dealing with diseases

Do not delay a visit to the doctor and the passage of the diagnostic survey. Chronic thyroiditis without proper timely treatment leads to an increase (hyperthyroidism) or a decrease in (hypothyroidism) of the thyroid function. Based on the diagnostic examination, the attending endocrinologist appoints a medical course. In addition, the age of the patient is necessarily taken into account, the presence of concomitant diseases.

Drug therapy with prescription of drugs

In order to reduce the generation of antibodies, non-steroidal anti-inflammatory agents are prescribed, immox-corrective drugs, adaptogens.

Also prescribe the drugs of immunomodulating therapy, which is aimed at normalizing immunity. Experts are discharged vitamin complexes, aminocaproic acid, heparin. The result of medication therapy is the normalization of the function of the thyroid gland.

It should be borne in mind that drugs in most cases will have to take a lifetime. Many of the medicines have serious side effectswhich affect cardiac activity, menstrual cycle and other systems.

Surgical intervention

TO surgical treatment - the removal of the thyroid gland is resorted to very serious indications and the development of complications. Operational intervention is mandatory if it is impossible to breathe or take food due to inflammation, if drug therapy does not help.

It should be borne in mind that the complete removal of the thyroid gland does not stop the autoimmune process, but on the contrary, speeds up.

Hatch of any form requires immediate treatment. It is very important to start timely treatment At the moment when pathology is just beginning to progress. However, it should be borne in mind that the treatment does not guarantee on the complete recovery. Because a disease is chronic, recurrence is possible. In any case, competent and proper treatment It will help slow down the process of the development of the inflammatory process and will help to achieve long-term remission of the disease.

Treatment with folk remedies

Chronic autoimmune thyroiditis in a complex with basic medication therapy can be treated folk methods. Many folk remedies Painting effectively facilitate pain. Before using any means of traditional medicine, you must consult with the attending physician.

A small list of effective and common products used as a means of traditional medicine in the treatment of disease associated with inflammation of the gland:

Sea cabbage contains a large amount of iodine and minerals required for the holistic functioning of the thyroid gland. Recipe based on sea cabbage is quite simple: one teaspoon of crushed red pepper, mixed with cabbage. The resulting mixture, flooded with boiling water, you need to insist approximately 7-8 hours, and after strain and take the resulting decoction of 50 g within two weeks. Use 3 times a day before meals.
Walnut - green fruits. Crumpled nuts with natural honey and vodka are mixed with natural honey and vodka. The final product is placed in a cool darkened place and insisted for two weeks. Then it is filled and again allowed for another week. Take the resulting tincture is necessary on the tablespoon before eating 1-in times a day.
Pine kidneys, which are in a flip of form poured with vodka in proportions: on a two-liter kidney can - liter of vodka. It is necessary to insist in a dark place for two weeks. The obtained alcohol tincture is recommended to rub inflamed foci.
Phytotherapy - Various herbal teas And decoctions.

Compliance with food reception rules

The main and most important rule in the treatment of the inflammatory process of the thyroid gland is the observance of the diet. It should not be a strict low-calorie diet, but all the right full nutrition. First of all, in the diet of food, products containing vitamins A, B and D. Meat products, vegetables and fruits, mandatory dishes in the diet.

It is also fundamentally in this matter to compliance with fractional nutrition: use food is needed by small portions, several times a day.

Complications

Thareloit Hashimoto is enough serious diseasewhich often leads to adverse consequences for human life and health. Since the thyroid gland plays an important role in the full functioning of all organs, with any of its violation there is a failure in the work of all organs.

Activities are violated nervous system. The patient becomes irritable, prone to depression, panic attacks;
Heart disease develop, blood pressure is disturbed;
There is a change in cholesterol content in the blood;
It is possible to rebirth the disease in a malignant form.
As a result of hormonal background, women may have a failure of the menstrual cycle, which may cause the development of the disease of the ovaries and infertility.

In order to prevent the development of complications and unpleasant consequences, it is important to identify chronic autoimmune thyroiditis in time and start appropriate treatment.

Prevention

Thyroiditis Hashimoto requires an attentive relationship and treatment approach. It is worth protecting the adverse factors provoking the development of inflammation of the thyroid gland and comply with simple preventive measures:

News healthy image life, observing a balanced diet and eliminating bad habits;
Avoid prolonged stay under direct sunlight;
Until the end to treat colds, not allowing the transition to a chronic form.

Even with an effective result of treatment and recovery, the patient needs to be regularly observed from the endocrinologist and follow the state of the thyroid gland.

Chronic autoimmune thyroiditis (ait or hut) (thyroidita Hashimoto, chronic lymphocytic thyroiditis) is an autoimmune inflammatory disease of the thyroid gland (thyroid), which is accompanied by its lymphocytic infiltration with subsequent fibrous substitution. According to the results of medical literature, 90% of cases of primary hypothyroidism (insufficient imaging function) are a consequence of this autoimmune disease. For the first time this disease was described in 1912. H. Hashimoto.

Ait is a very common endocrinological disease. This violation of the body's condition is 10-15 times more often observed in women than in men. In this case, the peaks of morbidity are noted in the pubertal period, after abortion, pregnancies, childbirth, over the age of 35, in the preclimberic and postmenopausal period.

Why develops?

The exact reason for the development of this disease is unknown to the end. At the heart of autoimmune thyroiditis, as well as in any autoimmune disease, there is genetic pathology, namely from HLA (human leukocyte antigens). This genetic predisposition determines the higher risk of developing this disease with a violation of the immune response of T-lymphocytes, which interact with initiating and inducing factors (the effects of the external environment, infection (bacterial and viral), anthropogenic pollutants, etc.).

It takes place in 25-30% of cases family history of autoimmune thyroiditis. Asymptomatic carriage of antibody (AT) to thyroid peroxidase and thyreoglobulin is registered in 56% of sibs and at least one of the parents.

In other words, in the role of a provocation element, any damage to the chart, which leads to admission to the blood of thyroid antigens (AG). As a result, a genetically predisposed person, the immune system perceives these ags as foreign and begins to attack the pin (by forming antibodies to various components of the thyroid gland). This leads to a substitution with a connective tissue of damaged iron parenchyma. As a result, an insufficient function of the gland itself (hypothyroidism) is formed.

The occurrence of the disease is associated with the survival of "prohibited" clones of T-lymphocytes and the synthesis of antibodies to thyroid receptors.

A combination of ait can be observed with another autoimmune pathology, such as:

diffuse toxic goiter (DTZ);
miasti;
infiltrative (autoimmune) ophthalmopathy;
stachen syndrome;
alopecia;
vitiligo;
lymphoid cell hypophysuit;
collagenoses.

Clinical manifestations

Ait has no specific symptoms, and individual manifestations are characterized by "multipleness". In most cases, asymptomatic / subclinical options are characteristic of this disease.

Hypertrophic (nodal, okurbaya) and atrophic forms of autoimmune thyroiditis are isolated. Hypertrophic AIT is found in 65-80% of cases and is manifested by a progressive increase in dimensions and slow increasing the insufficient inference function. The main complaints of patients are associated with an increase in the size of the gland itself. In other cases, atrophic ait is recorded in patients and is characterized by a decrease in the size of the pin up to atrophy. Often this form proceeds under the mask nodal zoba With the slow development of hypothyroidism.

Frequently often in the older age groups there is a combination of AIT and the self-assembly pathology of the pin - as a benign (cyst, adenoma, nodal colloid goiter, cystamoma) and malignant (lymphoma, follicular, papillar, atypical forms of cancer, etc.).

The complaints are quite common in discomfort, the "feeling of hoop", the feeling of "giveaway" in the field of the front surface of the neck, which is enhanced during night sleep. No connection between the sizes of the pin and the degree of expression of the symptoms of the disease.

Depending on the functional state Complaints of patients may reflect the symptoms of hyperthyroidism / thyrotoxicosis or subclinical / manifest clinical hypothyroidism.

Hypothyroidism is developing gradually, most patients at the time of appeal to the endocrinologist are in a state of eutyroid (no imagine function) or subclinical hypothyroidism. In 10% of patients at the beginning of the disease, a short phase of hyperthyroidism is observed (hasitoxicosis), which is associated with the destruction of follicular epithelium cells (destructive thyrotoxicosis). In the future, hypothyroidism develops as a result of replacing the penshima of the pin with a connecting cloth.

Diagnostics

The diagnosis of autoimmune thyroiditis takes into account the following data:

family history (the presence of ait or other autoimmune pathology in relatives);
an objective inspection (symptoms of hypothyroidism, a dense consistency of the thyroid houses during tackling);
laboratory studies (hypothyroidism, antibodies to TPO);
instrumental research (ultrasound, scintigraphy).

When diagnosing the disease, it is important to estimate the combination with another autoimmune pathology.

AIT diagnostic criteria were proposed. The disease is installed only when a combination of 3 signs is detected:

detection of diagnostic levels of anti-random AT (most informatively determining the levels of AT to TPO);
the presence of a specific ultrasonic picture (thyroid hypo echogenicity);
confirmation of the presence of primary hypothyroidism in terms of thyrotropic hormone (TSH).

Availability of 2 of the 3 listed features allows you to verify a probabilistic diagnosis in the absence of hypothyroidism. The combination of any of the listed features with hypothyroidism allows you to make a diagnosis of autoimmune thyroiditis.

The functional decline in the chance in children and adolescents with AIT is not a mandatory symptom of the disease and cannot serve its main diagnostic criterion. Although it should be regarded as a result of AIT in the presence of acquired primary hypothyroidism at this age.

Symptoms of AIT on ultrasound is the detection of an increase in the size of the curve and both fractions, diffuse or motley decrease in the echogenicity of the tissue of the pin. The sensitivity of this technique reaches about 85%.

The thin game aspiration biopsy is used not to verify the diagnosis of AIT, but to eliminate the combination of AIT with the nodal pathology of the pin.

Conducting scintigraphy is impractical. The presence of hypothyroidism and destructive thyrotoxicosis is characterized by the absence of the seizure of the radiopharmacological drug by the thyroid house - "mute iron".

The AT's carrier to TPO with the preserved clutch function predetermines a significant increase in the risk of the development of hypothyroidism.

There are only 3 methods for the treatment of autoimmune thyroiditis:

medicines;
operation or radioactive iodine;
recovery treatment of the CRT.

Learn from other errors: Hormone reception and operations do not eliminate the cause of autoimmune thyroiditis

The first method - HGT (replacement hormone therapy) (or drug therapy with drugs). This is a regular reception or substitution of hormone missing with synthetic analogues. The UGT does not eliminate the development of autoimmune thyroiditis, but only reduces its manifestation on analyzes for some time.

As a result of such a "treatment", the disease progresses, all major doses of drugs are required, which is associated with the lack of recovery leads to numerous side effects and disorders of the digestive, cardiovascular, nervous and reproductive system of a person. On the danger and therapeutic uselessness of the UGT in more detail.

Before deciding on the "treatment" method, we recommend that you search for real patient reviews on the Internet or familiarize yourself with the reviews of our patients who tried to recover in such years. For obvious reasons, we do not use the UGT in our practice, and on the contrary, we gradually remove the dependence of patients from taking synthetic hormones.

Surgery. With autoimmune, thyroid is prescribed in advanced cases or with large thyroid volumes to stop excessive generation of the immune antibody system. Those. Instead of eliminating the cause of the disease, the thyroid gland is offered to partially or completely remove the scalpel or laser. As an alternative to completely stop the work of the thyroid gland without surgery, it is proposed to irradiate with radioactive iodine.

The last method of course "safer" surgical operations, but the removal of the thyroid gland anyone The method leads to a hazardous disability. Autoimmune processes in the body are not going anywhere and are now controlled lifetime SGT. In addition to the violation of the digestive, cardiovascular, nervous and reproductive human systems, you get lifetime hypothyroidism and other chronic diseases.

For more than 20 years there is a safe treatment of autoimmune thyroiditis without hormones and operations by computer reflex therapy (CTR)

In our medical center In the city of Samara, there is a complete restoration of the function, structures and volume of the thyroid gland without hormones and operations.

The indicative REC result for one of our patients, which once again recovered the results for hormones in its regional clinic:

FULL NAME - Faisullina Irina Igorevna

Laboratory study Before treatment M20161216-0003 OT 16.12.2016 ()

Thyrotropic hormone (TSH) - 8,22 ICME / ml

Laboratory study After 1 course CRT M20170410-0039 OT 10.04.2017 ()

Thyrotropic hormone (TSH) - 2,05 ICME / ml

Thyroxin free (T4) - 1,05 ng / dl

What is the secret of such results?

Cause of recovery in the restoration of the patient's own neuro-immuno-endocrine regulation

The fact is that consistent work internal organs Our body is regulated by the coordinated interaction of 3 main control systems: nervous, immune and endocrine. It is from their synchronous and coordinated work that the physical condition and human health depends on. Any disease progresses and the body cannot independently handle it because of failure in synchronous work of these systems.

KRT through the vegetative nervous system "reboots" the work of the three main regulatory systems of the body to the state active struggle from current diseases.

Methods of impact on the nervous system there are many, but only computer reflex therapy For 20 years, proved that patients are fully restored neuro immuno-endocrine regulation of the body and, as a result, many endocrine and neurological diseases are receded and completely disappeared, which were previously not amenable to medication "treatment".

Efficiency Therapy is also the fact that the doctor affects the patient's body not "blindly", but, thanks to the special sensors and the computer system, sees what points are points nervous system I. how much Requires a medical device.

KRT externally can resemble acupuncture, but it is not, because Works without the use of needles and on other principles.

The CRT, like any treatment method, has its own contraindications to use: oncological diseases and mental disorders , Availability cardiomimulatorflickering arrhythmia and miacard infarction in the acute period HIV-Infection I. congenital hypoteriosis.

If you do not have the presented contraindications, then restore your own hormonal balance and get rid of autoimmune thyroidity with this method In our center for many years it is common practice.

Treatment of autoimmune thyroiditis by computer reflex therapy Without side effects, leads to the following results:

the growth of nodes and cyst is suspended, they gradually decrease in size and, most often, are completely absorbed;
restore the volume of the functioning tissue and the structure of the thyroid gland;
the synthesis of its own thyroid hormones is restored, which is confirmed by the ultrasound data and the normalization of the level of hormones of the TTG thyroid gland and T4;
the activity of autoimmune processes in the thyroid gland is reduced,which is confirmed by a decrease in the titer of antibodies of Atto, Attg and AT to TTG receptors;
if the patient takes hormone-substituting drugs, it is possible to reduce their dosage and over time to completely cancel;
restored menstrual cycle;
women can implement a childbearing function without using Eco and give birth to a healthy child with normal level hormones;
in addition, the patient's biological age decreases, health is strengthened, the weight is reduced, swelling goes. That is why additional procedures and programs for the natural rejuvenation of the face appeared in the clinic.