Presentation on theme: "Terry Kotrla, MS, MT(ASCP)BB"— Presentation transcript:
1 Terry Kotrla, MS, MT(ASCP)BB Unit 3 Autoimmunity Part 4 Hashimoto’s Thyroiditis Part 5 Grave’s DiseaseTerry Kotrla, MS, MT(ASCP)BB
2 Hashimoto's Thyroiditis A type of autoimmune thyroid disease in which the immune system attacks and destroys the thyroid gland.CHARACTERIZED BY HYPOTHYROIDSM.Thyroid helps set the rate of metabolism - the rate at which the body uses energy.Hashimoto’s prevents the gland from producing enough thyroid hormones for the body to work correctly.It is the most common cause of hypothyroidism.Have statistically increased risk of developing other disorders: Diabetes, rheumatoid arthritis, TTP, SLE
3 Hashimoto's Thyroiditis Organ specific disease affecting the thyroid gland.Can occur at any age, most often seen in women 30 to 40 years old,May be a genetic predisposition.Causes diffuse hyperplasia in the gland resulting in development of a goiter.Thyroid autoantibodies are formed.
4 Symptoms Similar to those of hypothyroidism in general Often subtle and not specific.Become obvious as condition worsensThe following are the most common symptoms. :Goiter (enlarged thyroid gland may cause a bulge in the neck)FatigueModest weight gainCold intoleranceExcessive sleepiness.Vague aches and painsSwelling of the legs
5 ThyroidThyroid hormones are produced by the thyroid gland. This gland is located in the lower part of the neck, below the Adam's apple.The gland wraps around the windpipe (trachea) and has a shape that is similar to a butterfly - formed by two wings (lobes) and attached by a middle part (isthmus).A goiter forms due to inflammation of the thyroid.
6 GoiterThis enlargement is due to the inflammatory cells which destroy thyroid cells, resulting in long term scarring.When the cells are damaged they cease thyroid hormone production, resulting in hypothyroidismA goiter only needs to be treated if it is causing symptoms.The enlarged thyroid can be treated with radioactive iodine to shrink the gland or with surgical removal of part or all of the gland (thyroidectomy).Small doses of iodine (Lugol's or potassium iodine solution) may help when the goiter is due to iodine deficiency.
7 Laboratory TestingRoutine thyroid function tests to confirm that a patient has an underactive thyroid gland.Thyroid stimulating hormone (TSH) - highFree T4 (thyroxine) –low but may be normal early in diseaseAnti-thyroid antibodies produced and attack specific portions of the thyroid cells which pinpoint Hashimoto's thyroiditis as the cause of the hypothyroidism.Anti-microsomal antibodiesAnti-thyroglobulin antibodiesThe anti-microsomal antibody test is much more sensitive than the anti-thyroglobulin, therefore some doctors use only the former blood test.Thyroid autoantibodies blood tests are high in about 95% of patients with Hashimoto's thyroiditis, but are not diagnostic.
8 Treatment Thyroid hormone replacement. Spontaneous remissions have occurred.
9 Graves’ Disease - Thyrotoxicosis Autoimmune diseaseAntibodies attack thyroid gland causing overproduction of thyroxine.Thyroxine greatly increases the metabolic rate.Most common cause of severe HYPERTHYROIDISMCan occur in children and adolescents but women more susceptible, occurs most frequently between 30 and 40 years of age.Genetic link suspected.
10 Graves’ DiseaseDiagnosis may be straightforward, since the "classic face" with its triad ofhyperthyroidismgoiterexophthalmosGoiter is usually symmetric, smooth, and nontenderThe hyperthyroid state can cause a wide variety of multisystem derangements that often result in diagnostic confusion.
11 ExophthalmosExophthalmos, also called proptosis, is a characteristic finding in thyroid eye disease, and has been reported to occur in 34% to 93% of patients
12 Signs Symptoms Causes a number of symptoms Nervousness and increased activityfast heartbeatfatiguemoist skinheat intoleranceshakinessanxietyincreased appetiteweight lossinsomnia.Have at least one of the following: goiter, bulging eyes, or raised areas of skin over the shins.
13 Laboratory TestingPresence of thyroid-stimulating hormone receptor antibody, causes release of thyroid hormones.Key findings areElevated total and free T3 (triiodothyronine)Elevated T4 (thyroxineThyroid stimulating hormone (TSH) is reduced due to antibody stimulation of the thyroid.
14 Treatment Medication. Radioiodine therapy to destroy the thyroid. Surgical removal of thyroid
15 The EndSubmit your answers to the 4 questions found in this presentation.