CHAIT 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 autoimmune thyroiditis of the thyroid gland (CHAT) is an inflammatory disease caused by autoimmune changes. The body, reacting 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, resulting in transient hypothyroidism.
CHAIT of the thyroid gland - what is it
A he althy person produces immunity to pathogenic bacteria and viruses, however, due to various functional abnormalities, autoimmune reactions occur. The specific reasons for the development of such a process still remain a mystery, but doctors have identified the relationship of this pathology with a genetic predisposition. Those with a family history of endocrine disease are at greater risk of developing thyroid CAI.
Why does it appear?
The following factors are capable of provoking the development of this disease:
- viral and cold infections;
- caries;
- chronic sinusitis, otitis, tonsillitis;
- harmful environmental conditions;
- long-term iodine therapy;
- diabetes mellitus;
- radioiodine therapy;
- exposure to radiation;
- chronic system problems;
- excessive emotional shock.
Risk groups
There are several causes of diffuse changes in the thyroid gland like CAI.
- Hormonal failures. This reason is the most common. In this case, diffuse changes in the thyroid gland in CAI occur according to the type of 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 areas of residence, especially in endemic regions. Residents of such places are at increased risk.
- Impaired activity of the autoimmune system. Inflammation originates in the cells of the thyroid gland. This process is accompanied by deviations in the work of the immune system. In such a situation, it does not work correctly, perceives the organ as foreign. In this case, antibodies are produced in the body that attack the thyroid gland. If the immune system is working properly, this cannot happen.
- Unhe althy food. Against the background of a constant lack of food necessarybody iodine volume 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.
CHAIT 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 estrogens on the female body and disorders of the X chromosome. HAIT accounts for about 30% of all diseases of the endocrine system.
Clinical picture
CHAIT 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 may increase, which is accompanied by strong compression of the esophagus, blood vessels, trachea and nerve receptors.
The main sign of thyroid HAIT at this stage is an unpleasant sensation of having a foreign object in the throat. It becomes difficult for a person to swallow, pain in the neck area can be observed with sudden turns of the head. Unpleasant sensations intensify at times at the time of palpation. In addition, people suffering from this disease often complain of general weakness, aching joints and muscles, and fatigue too quickly.
At the initial stage of CAITI of the thyroid glandthyrotoxicosis 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 T4 and T3 reserves from damaged thyroid follicles.
Symptoms of thyrotoxicosis in CAI are most often the following phenomena:
- loss of appetite;
- abnormal weight loss;
- vomiting and nausea;
- high blood pressure;
- facial swelling;
- yellowing of the skin;
- excessive sweating;
- tachycardia;
- bulging eyes.
Features of flow
With CAI, thyrotoxicosis has a transient 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 T4 and T3 deficiency are more pronounced under the influence of harmful factors: excessive overwork, stress, a period of exacerbation of chronic ailments.
When CAI thyroid symptoms are as follows:
- low blood pressure;
- arrhythmia;
- depression, irritability;
- facial swelling;
- tremor of legs or arms;
- brittle nails, excessive hair loss;
- insulin resistance;
- Abnormal weight gain that is difficult to get rid of.
Classification
Due to the peculiarities of the clinical picture, autoimmune pathology is conditionallysubdivided into several types:
- With latent thyroid CAI, there are practically no symptoms. The organ itself is of normal size or slightly enlarged, the activity is not disturbed.
- The hypertrophic type of CAITI 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 quite likely. In the hypertrophic form of HAIT, the work of the thyroid gland, as a rule, does not suffer. Extremely rarely, thyrotoxicosis is detected at the initial stage, which eventually flows into hypothyroidism.
- The atrophic variety of HAIT does not provoke an increase in 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 elderly people and young girls after radioiodine therapy.
Phases of HAIT
The development of this pathology can be conditionally divided into several stages with typical symptoms:
- Euthyroid phase - the normal activity of the thyroid gland remains, the person has practically no signs of the disease, the general state of he alth 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, due to which the amount of thyroxine reaches normal levels.
- The thyrotoxic phase is characterized by typical symptoms of thyrotoxicosis. Into the bloodstreammany damaged thyroid follicles penetrate, which continue to produce hormones. At the same time, the immune system begins to produce an increased amount of antibodies, which aggravates the course of CAI.
- The hypothyroid stage occurs against the background of T4 and T3 deficiency. There are changes in the thyroid gland according to the type of HAIT, its activity slows down, the area of the 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.
CHAIT is able to systematically flow from one form to another or manifest itself only as 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 patient is examined and questioned by an endocrinologist, 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 may be detected.
With the help of laboratory tests for the concentration of thyroid hormones, it is possible to determine the stage of CAITI. With thyrotoxicosis, the level of T4 and T3 will be increased several times, and TSH remains in normal amounts. The hypothyroid phase proceeds with a reduced concentration of thyroxin, as well as an increased or normal level of thyroid-stimulating hormone.
ELISA examination allows to detect antibodies to thyroproxidase, colloidalantigens, thyroglobulin, thyroid tissues. The results of the complete blood count show an increased number of lymphocytes and a reduced concentration of leukocytes.
Clarification of the diagnosis
Ultrasound is performed to determine the general condition and size of the thyroid gland. If there are seals in it, a fine-needle aspiration biopsy is performed, which is needed to study the tissues of the node and detect tumor cells.
Diagnosis can be confirmed by detecting anti-ATPO antibodies, signs of hypothyroidism, and thyroid hypoechogenicity.
In addition, differential diagnosis of autoimmune pathology of Riedel's goiter, nodular goiter, organ cancer and de Quervain's thyroiditis is required.
Treatment of CAITS of the thyroid gland
Specific therapy is needed only at the thyrotoxic and hypothyroid stages of the disease. Indeed, in the subclinical and euthyroid phase, the thyroid gland remains normal, the person does not feel any discomfort.
With an increased concentration of thyroid hormones, the patient is not prescribed thyreostatics, which inhibit the excessive production of T4 and T3, since the initial cause of the problem is definitely not hyperfunction of the thyroid gland. Hypothyroidism 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. It is very important to systematically examine the blood for hormone levels. The appropriate dosage is selected according toon an individual basis, depending on the age of the patient, his weight, general well-being, as well as the presence of defects in the cardiovascular system.
Features of therapy
To lower the number of antibodies, doctors usually prescribe adaptogens and immunosuppressants. Non-steroidal anti-inflammatory drugs like Nise, Diclofenac and Nurofen can reduce pain and reduce inflammation. If HAIT proceeds in parallel with subacute thyroiditis, glucocorticoids are used - Dexamethasone and Prednisolone. If the activity of other organs and systems is disturbed, symptomatic treatment is carried out.
If the thyroid gland grows in size too quickly, putting pressure on nearby structures, is abnormally located, or has too many large nodes, the patient is scheduled for surgery, which involves partial or complete removal of the damaged organ.
Further forecast
Chaitis of the thyroid gland is usually characterized by a progressive course. Provided that supportive therapy is carried out in a timely manner, the hormonal balance is restored and all the instructions of the endocrinologist are followed, in about 85% of all cases it is possible to achieve a positive result and a long stage of remission.
The working capacity of people suffering from subclinical type CAI is maintained for at least 20 years after the onset of the disease. If the patient does not receive adequate treatment, there isa persistent form of hypothyroidism, there are deviations in the activity of the cardiovascular system and the digestive tract, diabetes mellitus appears.
