Focal thyroiditis of the thyroid gland. Thyroiditis: types, causes, symptoms, diagnosis, treatment. Approaches to the treatment of autoimmune thyroiditis

The term “thyroiditis” refers to a wide group of diseases that can be described as inflammation thyroid gland. If left untreated, thyroiditis becomes chronic, causing hyperthyroidism, and subsequently hypothyroidism, which especially often occurs with Hashimoto's thyroiditis.

The causes of thyroiditis are inflammation of the thyroid tissue

The causes of thyroiditis of the thyroid gland can be different, as well as their mechanism, but this broad group of diseases has one common features- the presence of an inflammatory focus in the thyroid tissue.

Classification:

There are several forms of this disease. So, depending on the nature of the flow and clinical features, highlight the following:

• spicy;
• subacute;
• chronic thyroiditis.

Depending on the conditions and causes of occurrence, there are:

1. Autoimmune thyroiditis
2. Syphilitic
3. Tuberculosis

Acute thyroiditis affects either the entire gland or parts of it

May be:

1. Diffuse

2. Ochagovym

Diffuse spreads to the entire gland or entire lobe. Focal partially affects the thyroid lobe. The inflammatory process in this form of the disease can be purulent or occur without suppuration.

This type of disease is distinguished by:

1. prevalence.
2. clinical forms.

In the first case, it can be focal or diffuse. In the second, there are 3 types of thyroiditis: pneumocystis and lymphocytic.

Chronic thyroiditis develops only due to untimely treatment

This is a group of thyroiditis, which includes the following varieties of this form of the disease:

1. Autoimmune thyroiditis of the thyroid gland or Hashimoto's thyroiditis.
2. Fibrous-invasive goiter of Riedel.
3. Specific thyroiditis of different etiologies (syphilitic, tuberculous, septomycosis).

Riedel's goiter and purulent form acute thyroiditis.

The main symptom is enlarged lymph nodes

The acute purulent form develops after pneumonia, tonsillitis and other infectious diseases, in which the causative agents of these diseases enter the tissues through the hematogenous method.

The acute non-purulent form occurs after hemorrhages in the thyroid tissue, as well as after its radiation and traumatic injuries.

Subacute de Quervain's thyroiditis. The second name for this form is Granulomatous thyroiditis. It is based on viral damage. Viruses, measles, influenza, adenoviruses and causative agents of other infections affect the cells of the thyroid gland, which is 5-6 times more common in women aged 20 to 50 years. Clinical signs of subacute thyroiditis become noticeable several weeks after the infectious disease. Outbreaks of infection directly depend on periods of viral activity. This form occurs ten times less often autoimmune thyroiditis and it is characterized by reversible disturbances in the functioning of the gland. The cause of subacute thyroiditis, as a rule, is genetic factors and chronic nasopharyngeal infections.

Riedel's goiter or fibrous thyroiditis compresses the structures of the neck due to significant growth connective tissue. However, its etiology has not been fully elucidated. Some experts consider this disease to be the result of Hashimoto's thyroiditis after damage to the gland by autoimmune processes.

The development of Riedel's goiter is more common among patients with endemic goiter who have undergone operations on thyroid gland and, in persons with allergic and autoimmune diseases, as well as those with a hereditary predisposition.

Symptoms of thyroiditis depend on stage C and the complexity of inflammation of the nodes

Thyroiditis manifests itself as painful sensations and pressure in the neck. Other symptoms of thyroiditis include hoarseness and difficulty swallowing. Acute inflammation provokes the formation of an abscess. Further development of thyroiditis is determined in the thyroid gland diffuse changes, which, as the disease progresses, lead to disruption of its functions.

The purulent form of this disease is distinguished by the presence of an inflammatory process in which the thyroid gland is infiltrated, and subsequently the formation of an abscess is observed in it.

Purulent thyroiditis

Is different acute development, begins with chills and temperature up to 40°C. The patient experiences sharp pains in the area of ​​the front of the neck, while there is an increase in pain when moving the head, coughing and swallowing, their displacement in the jaw, back of the head, tongue, ears. Phenomena general intoxication rapidly increase: tachycardia appears, weakness appears, the patient experiences weakness, aches in the joints and muscles, severe headache.

Often the patient has a serious condition.

Acute thyroiditis, non-purulent form

Leaks with less severe symptoms and is characterized by aseptic inflammation of the thyroid tissue.

Subacute thyroiditis

May have clear signs inflammation. The course of this form of thyroiditis is characterized by pain in the anterior cervical surface, weakness, temperature of 38°C and above, severe intoxication with increasing severity. With this form of thyroiditis, there is a duration of acute initial stage thyrotoxicosis from 4 to 8 weeks, and after treatment of thyroiditis, it ends with recovery with restoration of the function and structure of the gland.

Chronic fibrous thyroiditis

Its course may not cause any disturbances in well-being for a very long time. Early manifestation fibrous chronic thyroiditis- feeling of a “lump in the throat” and difficulty swallowing. Next, hoarseness of the voice, disturbances in swallowing, breathing, speech, and choking while eating develop. The thyroid gland is painless, its functional activity is reduced. Chronic thyroiditis causes compression of adjacent structures in the neck.

Compression syndrome occurs with visual impairment, headache and tinnitus. In the chronic form there is pulsation cervical vessels, the patient complains of breathing problems and difficulty swallowing.

Autoimmune thyroiditis or Hashimoto's thyroiditis

Chronic autoimmune thyroiditis was first described in detail by physician Hashimoto from Japan. Autoimmune thyroiditis develops when the body mistakes its own proteins for foreign ones, which causes an autoimmune reaction in the thyroid gland - infiltration of lymphocytes. Chronic autoimmune thyroiditis develops slowly and causes destructive processes in the thyroid gland.

Hashimoto's thyroiditis is most often observed in women over 40-50 years of age, although it can occur among younger children and adolescents. Treatment of autoimmune thyroiditis is complicated by the fact that at first, its symptoms are almost invisible, and the diagnosis is not always timely.

Symptoms of autoimmune thyroiditis may for a long time does not manifest itself, then an enlargement of the gland and a change in its structure are noted. The thyroid gland is compacted and bumpy to the touch. Initially, a patient with Hashimoto's thyroiditis complains of malaise and swelling in the neck, experiences discomfort, and pain begins in the area of ​​the thyroid gland, especially when swallowing. Pain also occurs when chewing solid food, when turning, or tilting the head.

There may be an excess of thyroid-stimulating hormones. But more often, chronic autoimmune thyroiditis causes hypothyroidism - a decrease in hormones.

Treatment is carried out with the help of medications

To properly treat chronic autoimmune thyroiditis, the endocrinologist clarifies the condition of the gland and prescribes the following tests:

• immunological blood test;
• blood test for hormones.

Treatment methods for autoimmune thyroiditis include drug replacement therapy with constant monitoring of the patient. Sometimes chronic autoimmune thyroiditis requires surgical intervention, and according to very serious indications it is performed complete removal glands.

If the disease is detected on time, then treatment of autoimmune thyroiditis gives good result and the prognosis is favorable.

Thyroiditis is usually called an inflammatory process in the thyroid gland. Clinical manifestation thyroiditis is not the same, so there are several forms of inflammation of the thyroid gland, one of which is long-term and is called chronic thyroiditis. The disease belongs to the group of autoimmune pathologies of the gland. The main group of patients with chronic inflammation of the thyroid gland are elderly women. However, the disease is not limited only to the choice of this category of humanity; representatives of the male sex, young women, and children are less often registered with autoimmune disorders.

If no cases of autoimmune diseases have been found in a person’s family tree, then there is no need to worry about the occurrence of chronic thyroiditis. The likelihood of developing an autoimmune thyroid disorder increases if you have a family history. A pathological condition of an autoimmune nature is fraught with its manifestation, which may be absent for a number of years.

Clinical picture

The chronic form of thyroiditis develops without obvious signs, since the pathological state of individual cells is compensated by the double work of healthy thyrocytes. The increase in destructive metamorphoses leads to excessive concentrations of thyroid hormones in the blood or the appearance of symptoms of a hypothyroid state. Different shapes autoimmune disease appear in approximately 85% of cases high concentration autoimmune bodies to thyroid follicles. A more detailed clinical picture can be described when differentiating autoimmune pathology.

Stages of pathology

The disease develops according to the following scheme:

1. In the euthyroid phase, signs of conflict between antibodies and follicular cells are not detected. A blood test does not reveal changes in the levels of triiodothyronine and thyroxine. With such a pathological condition, a person can live from several months to the end of his life.
2. The subclinical phase is characterized by an increase in destructive changes in the thyroid gland. Measuring the level of thyroid hormones from the blood taken shows a noticeable decrease.
3. The thyrotoxicosis phase is noted as the peak stage of the disease. Damage to glandular thyrocytes leads to the release of thyroxine and triiodothyronine into the intercellular environment, from where they enter the blood. Excess thyroid hormones cause a thyrotoxic state. Beginning destruction glandular cells organ leads to the movement of individual fragments of destroyed cells into the blood. In response to visible changes, there is an increase in the produced antibodies to thyrocytes. At further progress pathological condition The thyroid gland shows a state of hypothyroidism.
4. The patient usually remains in the hypothyroidism stage for 1-2 years. After the specified period, the functionality of the thyroid gland is restored. Last stage is not always characteristic of the course of the chronic form of thyroiditis. The stage of thyrotoxicosis may be the last in the development of the pathology.

Types of disease

Chronic thyroiditis can develop in several directions depending on the manifestation clinical picture and morphological metamorphoses of the thyroid gland:

1. Hidden or latent form, with which external manifestations no pathology is noted. The course of the disease can only be guessed by immunity disorders. The thyroid gland is within normal limits or slightly enlarged. The functionality of the thyroid gland is not impaired, there are no structural changes in the glandular tissue. In some cases, there is a slight change in the concentration of thyroid hormones in the blood, both in the direction of hypothyroidism and in the thyrotoxic direction.
2. Hypertrophic form, accompanied by multiple formation of nodes or diffuse enlargement of the organ. In this condition, the level of hormones in the blood decreases markedly.
3. Thyroid function is markedly reduced in the atrophic type of autoimmune disease. Similar condition endocrine organ typical for loading dose ionizing radiation or old age. With the total death of thyroid follicles, the functionality of the thyroid gland is consistently low.

Nodular type of pathology

Nodules often accompany chronic thyroiditis. During autoimmune inflammatory reactions, damage to follicular thyrocytes occurs varying degrees gravity. Ultrasound reveals structural changes in gland tissue and its hyperplasia. Treatment of the disease is prescribed in accordance with the patient’s medical history and the disorders identified during the ultrasound examination.

Currently, medicine prefers conservative complex treatment of nodular formations in the chronic form of thyroiditis to surgical intervention. Part complex treatment The following methods are included:

1. preparations with iodine and hormone replacement therapy with Levothyroxine and its analogues;
2. treatment with herbs and other traditional medicine;
3. titration of antibodies shows a lower level if the patient improves his psycho-emotional state. The thyroid gland also begins to restore its structure due to the normalization of mental mood;
4. normalization of the psycho-emotional state occurs faster and easier if the patient uses art therapy, music therapy and other means of relaxation.

Lymphocytic form

The lymphocytic form of chronic thyroiditis affects a certain type of blood lymphocyte and, for this reason, this type of autoimmune pathology is considered organ-specific. T-suppressor cells, known as CD8 lymphocytes, trigger the mechanism of destruction as a result of chain reaction, during which T helper cells form pathological complexes with thyrocyte antigens. If the examined person has a complex of CD4 lymphocytes (T-helper cells) with a local antigen in the thyroid gland, then autoimmune pathology is hereditary. When lymphocytic thyroiditis is detected, a complex of other disorders of the thyroid gland is detected.

Only one out of twenty patients with lymphocytic chronic thyroiditis is a man, the rest of the patients are women. The disease occurs predominantly in women childbearing age with hyperplasia of the thyroid gland without other tangible signs. The main complaints of patients with gland hyperplasia are associated with bursting sensations in the neck and the occurrence of pressing pain. Less commonly, patients complain of changes in voice timbre or swallowing disorders.

Changes in the size of the thyroid gland are not always accompanied by noticeable symptoms. The determining factor in the formation of signs of hyperplasia is the state of hormones when the functioning of the gland is disrupted: decrease, increase or normal, euthyroid state.

Signs that appear

Chronic thyroiditis develops in two directions: lymphocytic and fibrous. Within these areas, several options for the development of pathological events are known:

1. autoimmune form;
2. Hashimoto's disease;
3. non-purulent form;
4. lymphomatous form; Riedel's goiter.

Although the autoimmune type of chronic thyroiditis is defined as hereditary disease, its development begins under the influence of provoking factors. These include viral infection upper respiratory tract, carious lesions of teeth, inflammatory processes in the tonsils, etc. It turns out that only hereditary predisposition cannot serve as the sole reason for the progression of pathology.

It was noticed that when high level Radiation exposure and uncontrolled use of iodine-containing drugs for a long time cause a failure of immune reactions, which results in immune aggression towards thyrocytes.

The onset of the disease is asymptomatic, perhaps some symptoms of mild intensity: pain in the thyroid gland upon palpation, “lump in the throat,” malaise and joint pain aching character. An enlarged thyroid gland can have a compressive effect on the throat.

At further development illness, symptoms characteristic of a hyperthyroid state occur: increased heart rate, excessive sweating, increased systolic pressure.

The development of the disease can occur in two directions: the atrophic nature of the gland and its hypertrophy.

With thyroid atrophy, hyperplasia is not observed; in the blood, when analyzed, a decrease in the concentration of thyroid hormones is detected. This form of pathology is typical for the elderly or people who have previously experienced a high dose of radioactive radiation.

With hypertrophic chronic thyroiditis of an autoimmune nature, diffuse hyperplasia or enlargement of the gland is detected due to the formation of nodular forms. In medical practice a nodular form is often detected against the background of a general increase in the size of the thyroid gland. The level of thyroid hormones in the blood is within the normal range or has a slight decrease, although forms with a significant excess of the normal concentration of thyroid hormones are not uncommon.

Diagnosis of thyroid inflammation

Examination of a patient with suspected chronic thyroiditis begins with an examination by an endocrinologist, palpation of the gland and anamnesis. The next stage of disease differentiation is blood donation for hormonal analysis and detecting the concentration of thyroid antibodies.

If there are no antibodies in the blood, a fine-needle test is performed. aspiration biopsy followed by cytological analysis.

Ultrasound gives a picture of changes in the structure and size of the gland. Malignant nodes No thyroid dysfunction was detected in this form. An important role in establishing a diagnosis is played by the hereditary pattern of gland conditions among close relatives and in the human family tree.

Features of treatment for chronic thyroiditis

There is no clear treatment plan for the disease. In the case of thyrotoxicosis, it is dangerous to prescribe drugs from the thyreostatic group due to an insufficient increase in the functionality of the thyroid gland. To reduce the thyrotoxic effect are prescribed medicines to relieve symptoms of the disease. Long and permanent state hypothyroidism is treated replacement therapy synthetic hormones such as Levothyroxine. Drug analogues begin to be used with a small dosage, gradually increasing it and achieving a normal concentration of thyroid hormones in the blood. Once every 60-70 days, the blood should be tested for thyroid-stimulating hormone levels.

If chronic thyroiditis is accompanied by a subacute form of inflammation of the thyroid gland, during the cold period a drug from the group of glucocorticosteroids (Prednisolone) is prescribed.

For hyperthyroidism and thyroid hyperplasia, the doctor may prescribe Thiamazole or its analogues.

When using Indomethacin or Voltaren, which are non-steroidal drugs to relieve inflammation, the symptoms of the disease subside.

Consequences and prognosis of the disease

If you have not had Hashimoto's thyroiditis long time treatment, severe hypothyroidism develops in the form of myxedema. Patients must exclude a number of other concomitant diseases (diabetes mellitus, ophthalmopathy, Graves' disease, adrenal insufficiency, etc.).

Disease prevention

Pregnant women should strictly follow the gynecologist's instructions if a thyroid dysfunction is detected. This form is dangerous in the first trimester, when there is a possibility of toxicosis or the threat of miscarriage.

To prevent thyroiditis, a diet is proposed that excludes animal fats and includes more fish, vegetables, lactic acid products, herbs, vitamins and cereals in the diet.

The drinking regime should be plentiful, but with the exception of gases. Dietary features will be dictated concomitant diseases with chronic thyroiditis.

The most commonly diagnosed inflammatory disease of the thyroid gland is called thyroiditis. That it is the most common thyroid disease in the world and the second most diagnosed among all diseases endocrine system(after diabetes mellitus), WHO publications also testify. However, there are no exact statistics, since the disease has a complex etiology. Some scientists believe that thyroiditis affects up to 50% of the population.

Thyroiditis of the thyroid gland - what is it?

Under common name“thyroiditis” is a group of inflammatory diseases of the thyroid gland. As a result of inflammation of the gland tissue, the production of thyroid hormones first increases significantly, hyperthyroidism occurs, and then the inflamed gland produces them less than normal (hypothyroidism occurs).

In some cases, the inflammatory process affects a small part of the thyroid gland, which happens rarely, the entire lobe (most often) or the entire gland. With a complicated course of thyroiditis, suppuration occurs, it can break through the skin, which is fraught with the penetration of pus into the blood and the development of sepsis.

Important. The most common type is autoimmune thyroiditis (Hashimoto's). In this form, the body begins to perceive healthy thyroid tissue as foreign and produces antibodies to it.

During the initial examination, it is quite difficult to determine the type and cause of thyroiditis of the thyroid gland. What it is can be said with certainty only after a series of tests.

Causes

Most common reasons the occurrence of thyroiditis is called infectious diseases: tuberculosis, syphilis, influenza, hepatitis A, measles, etc.

Some scientists consider endemic goiter to be one of the reasons for the development of thyroiditis.

In autoimmune forms, the cause is malfunction immune system. This form of thyroiditis occurs much more often in women than in men. The most likely age range is considered to be 40–50 years. However, doctors are increasingly detecting the disease in people much younger than this age.

Among the causes of inflammatory processes in the thyroid gland are also called:

• long stay in an area with a high radioactive background;
• frequent irradiation of the head;
• living in an area poor in iodine;
• consuming too much iodine in food;
• frequent colds and infectious diseases, etc.

Types, forms of thyroiditis and their symptoms

Thyroiditis has many classifications according to various characteristics:

• Depending on the etiology, they are distinguished: syphilitic, septomycosis, tuberculosis and other types.
• By age characteristics it can be divided into juvenile, senile, postpartum, etc.
• Inflammation can be classified as autoimmune thyroiditis or fibrotic thyroiditis.

The most widely used classification is according to the course of the disease: acute, subacute and chronic.

Acute form

This form of thyroiditis occurs rarely, it is considered the most severe, and can affect both the entire gland and part of it. With this disease, there is an increase The lymph nodes on the neck.

Acute thyroiditis can be purulent or non-purulent (aseptic).

Acute purulent thyroiditis

An abscess occurs in the thyroid gland. At the same time, body temperature rises to 39 ⁰C. It is painful for the patient to swallow. The pain intensifies when turning the neck and head, radiating to the back of the head, ears, and jaw. Severe headache and irritability occur against the background of general intoxication of the body.

The thyroid gland itself becomes dense at first, and then, after the formation of an abscess, soft, swollen and painful. Pain occurs when touching the organ.

Important. With purulent thyroiditis, the patient’s condition in most cases is assessed as extremely serious.

Acute non-purulent thyroiditis

With this type of thyroiditis, suppuration does not occur, only inflammation in a certain area of ​​the thyroid gland. Symptoms of non-purulent acute thyroiditis are less pronounced. The patient's condition is assessed as moderate.

Subacute form

This form of thyroiditis is characterized by a slow, gradual increase in symptoms. At first, the pain in the neck area is minor. Swallowing only causes discomfort. Gradually, the symptoms intensify: the pain becomes severe, radiates to the ears, jaw, back of the head, it becomes more and more difficult to swallow, the body temperature rises to 38 ⁰C, while (not always) the cervical lymph nodes become enlarged.

The course of the disease is long: up to 1.5–2 months. When researching hormonal levels there is a decrease in the body radioactive iodine, thyrotoxicosis, decreased hormone levels.

Subacute thyroiditis responds well to treatment and usually results in recovery.

Chronic form

Has very a long period course: up to 6–8 months. The most common chronic form is autoimmune thyroiditis (Hashimoto's thyroiditis). It affects approximately 6, and according to some data, up to 15 times more often women than men.

However chronic inflammation The thyroid gland causes more severe symptoms in men. Over a long period of time, a decrease in body temperature occurs, a slowdown in metabolic processes in the body, memory loss, lethargy, fast fatiguability, bad dream, digestive disorders, decreased fertility.

In invasive fibrous goiter (Riedel's disease), inflammation of the thyroid gland also occurs chronically. There is an opinion among some scientists that chronic form occurs almost always when there is various types endemic goiter.

Once again about the symptoms

Important! In the initial stage of the disease, thyroiditis symptoms are vague; they can be characteristic of diseases of other organs of the neck, as well as of other diseases of the thyroid gland. Acute thyroiditis manifests itself most clearly.

Among common symptoms thyroiditis of the thyroid gland:

• enlargement of the thyroid gland or part thereof;
• redness of the skin of the throat;
• pain when swallowing and turning the head.

At acute inflammation thyroid symptoms will appear sharply:

• pain in the neck, even when turning the head;
• problems with swallowing;
• increased body temperature, chills;
• enlarged cervical lymph nodes.

In subacute thyroiditis, symptoms appear gradually, pain in the neck increases slowly. There is a constant headache, weakness, sweating and a feeling of heat. There is tremor of the fingers. The skin over the thyroid gland turns red and swells, and the thyroid gland is painful on palpation.

In chronic autoimmune thyroiditis, the symptoms described above are accompanied by weight loss, tachycardia, tinnitus, and pain in the back of the head.

Autoimmune inflammation of the thyroid gland in women has less pronounced symptoms; in men, the disease is acute and the symptoms are pronounced.

Treatment of thyroid inflammation

Treatment of thyroiditis has several directions:

• It is important to restore hormonal balance if it is disturbed. For this purpose, treatment is carried out with tyrostatics (Mercazolil, Thiamazol).
• Non-steroidal anti-inflammatory drugs for thyroiditis (Metindol, Voltaren, Indomethacin) will help relieve inflammation, reduce swelling and soreness of the gland.
• Corticosteroid drugs (Prednisolone) for thyroiditis are used if its subacute form develops. They relieve inflammation, swelling and pain well.
• Also prescribed vitamin complexes, immune stimulants, adaptogens.

Acute purulent thyroiditis will require surgical treatment. Here, when an abscess occurs, it is opened and drained. In parallel, intensive detoxification therapy and antibiotic injections are prescribed.

For autoimmune inflammation of the thyroid gland in women, treatment is carried out for a long time. Often prescribed hormonal drugs thyroid gland for life.

In case of development of compression of the neck organs in chronic or subacute thyroiditis, surgical removal glands (thyroidectomy).

About folk remedies

He also offers his own recipes on how to treat thyroiditis. ethnoscience. The most common is rubbing the goiter with infusions. To do this, use an alcoholic infusion of green pine cones or extracts from their collection of herbs: cocklebur, celandine, chamomile and meadowsweet.

Juice therapy is also used; lemon, beet and carrot juices are used to treat pathology.

What it is?

AIT, autoimmune thyroiditis of the thyroid gland, is one of the forms of organ-specific pathologies of autoimmune genesis, characterized by inflammatory processes in the thyroid gland, causing lymphoid infiltration and destruction of the follicular tissues of the organ.

The disease has a hundred-year history and was first described by the Japanese surgeon Hashimoto. Subsequently, pathology began to be called after him -
"goiter or Hashimoto's thyroiditis."

Mostly women of mature age (45-60 years) are susceptible to the disease, which is due to an X-chromosomal disorder and the estrogenic effect on the cells of the lymphoid system involved in the immune response mechanism. In some cases it affects young people and children. Autoimmune thyroiditis occurs in more than 20% of pregnant women.

About causes and development

The genesis of the development of AIT is due to the phagocytic aggression of the immune system towards thyroid tissues, perceiving them as a foreign “agent” and producing antibodies to them. This fact causes autoimmune processes of inflammation and destruction of organ cells, including those producing hormones.

This explains the development of autoimmune thyroiditis, hypothyroidism and thyrotoxicosis, when there is a decrease or increase in hormonal synthesis. Among other things, autoimmune inflammatory processes in the tissues of the thyroid gland give impetus to the development of nodular neoplasms in them.

Autoimmune thyroiditis is classified as a genetically inherited disease, which is often confirmed by the presence of pathology in relatives close to the patient. But genetic predisposition not the only cause of AIT. Trigger phagocytic failure and hormonal dysfunction can:

• frequent pathologies of a viral and bacterial nature;
• chronic ENT infections;
• harmful environmental factors, provoking an increase in immune activity;
• excessive exposure to radiation and UV radiation;
• long-term uncontrolled use of hormones and iodine-containing drugs;
• iodine deficiency in the body;
• periods of hormonal changes;
• immune failure and predisposition to allergies
• surgical interventions on the thyroid gland and injuries;
• nervous pathologies and stress.

Such patients are often accompanied by other autoimmune diseases - diffuse processes in the thyroid gland ( Graves' disease), development of asthenic bulbar palsy(myasthenia gravis), endocrine Graves' ophthalmopathy, damage to the lacrimal and salivary glands due to “dry syndrome” of Shagren, collagenosis (connective tissue pathology), diffuse proliferation of lymphoid cells (lymphoid hypophysitis).

Symptoms of autoimmune thyroiditis by form

AIT has various variations, the genesis of all its types has the same nature of development, according to the type of aseptic inflammatory process, gradually taking the form of transient (transient) hypothyroidism. Manifests:

1. Autoimmune chronic thyroiditis is a consequence of immune phagocytic aggression, leading to destructive changes in the thyroid gland and causing development hypothyroidism.
2. Postpartum thyroiditis, developing as a result excessive activity phagocytic protection during pregnancy. In pregnant women predisposed to endocrine disorders, this type of pathology can subsequently transform into chronic autoimmune thyroiditis.
3. The type of painless thyroiditis (silent) is similar to the manifestation of postpartum thyroiditis, but the genesis is not associated with pregnancy.
4. A cytokine-induced type of disease develops in patients who have been treated with Interferon for a long time, with blood diseases and hepatitis C.

Clinical signs of disorders in the thyroid gland are determined by the form of AIT:

• Hypertrophic, characterized by a uniform increase in the entire thyroid gland or with signs of nodular formations. The functions of the gland are not impaired, or are slightly reduced. IN initial period thyrotoxicosis is possible. Progression autoimmune process leads to a decrease in function, deterioration of the condition and the development of hypothyroidism.
• Atrophic, the most severe form of autoimmune thyroiditis, provoked by an extensive process of destruction of follicular cells of the thyroid gland, sharply reducing its functions.

The AIT clinic is distinguished by a four-phase course of the disease: euthyroid, subclinical, thyrotoxic and hypothyroid, which replace each other and can last for years.

Autoimmune thyroiditis is characterized by a slow development of symptoms. Often the pathological process can be asymptomatic or with mild symptoms, which is characteristic of the euthyroid and subclinical phase. Thyroid cells are affected slightly and specially functional disorders no organ is noted. This course of the disease can last for decades.

Only slight discomfort may be felt in the thyroid area, in the form of a lump pressing on the throat, mild fatigue and weakness, and pain in the joints.

Main symptom autoimmune thyroiditis – growth of colloid goiter. The remaining signs are a reflection of a disturbance in the process of hormonal synthesis, its decrease or increase - hypothyroidism or hyperthyroidism (thyrotoxicosis). The clinical picture of thyrotoxicosis is usually observed in the first few years of development of the pathology.

As atrophic processes develop in the tissues of the thyroid gland, it is marked by a temporary transition into the ethyroid phase, followed by a transition to the hypothyroidism phase.

Persistent increase hormonal levels(with thyrotoxicosis) manifests itself:

• slight low-grade fever of the body;
• cardiac arrhythmia and hyperhidrosis;
• spontaneous shortness of breath, without the influence of stress;
• tremors in the limbs and weight loss;
• insomnia (insomnia) and neuroses (hysteria, irritability).

The hypothyroid phase of AIT is called the final phase, caused by the cellular destruction of most of the thyroid gland and insufficient hormonal synthesis by the remaining undamaged cells. Typical symptoms of decreased hormonal levels (hypothyroidism):

• chronic fatigue;
• significant weight gain;
• hypothermia (low temperature) and swelling;
• coarse facial features;
• diction defects, slowness and drowsiness;
• failures in menstrual cycle, signs of libido and infertility.

Treatment of autoimmune thyroiditis, drugs

The disease is diagnosed by palpation and ultrasound examination of the thyroid gland. Deviations of a serious nature are expressed by difficulties in swallowing and breathing caused by compression of adjacent organs. Changes in blood counts are noted due to inflammatory reactions in the thyroid tissues. Immunogram indicators help determine elevated or reduced level hormones. The diagnostic criterion is an increased level and aggression of antibodies in the thyroid gland - AT-TPO.

Most of the symptoms are characteristic of various pathological processes, which do not overlap with AIT, so appropriate differential diagnosis is carried out.

There is no clear treatment regimen for autoimmune thyroiditis. The therapeutic effect is aimed at relieving the symptoms of the disease depending on the phase of its course - thyrotoxic or hypothyroid. Includes:

1. Hormone replacement therapy.
2. Suppressive therapy hormonal function thyroid gland
3. If the organ is greatly enlarged, surgical intervention is required.

For AIT with signs of hypothyroidism, it is prescribed conservative therapy the drug “Levothyroxine”, “Mercazolil”, “Tiamazole”, and adrenergic drugs “Alpha-blockers”, aimed at hormonal regulation.

If the process has acute course glucocorticosteroid drugs are added - for example, Prednisolone. To reduce the aggression of antibodies to thyroid tissues, non-steroidal anti-inflammatory drugs are prescribed - Voltaren, Indomethacin, and others.

AIT - treatment with Endorm

The therapeutic complex also includes the treatment of autoimmune thyroiditis with Endorm. A drug is prescribed to weaken the attack of antibodies and replenish the thyroid tissue with macro and microelements. Homeopathic supplements included in the drug help restore the functioning of the adrenal glands and glands of the reproductive system, damaged due to hormonal imbalance.

Adaptogen preparations are also used to help the body adapt to harmful effects, vitamin complexes and immunomodulatory therapy.

The worst thing that can be expected from autoimmune thyroiditis is the development of autoimmune diffuse processes in various organs and systems of the body, indicating deep damage to the endocrine system.

Possible consequences

The consequences of autoimmune thyroiditis are rare and only in those cases where adequate treatment was not carried out.

• Among adult patients may progress mental disorders caused by depressive syndrome. Manifest as a syndrome of decreased and underdeveloped intelligence. Development of heart and vascular diseases.
• IN childhood manifest itself as underdevelopment of the organs of the reproductive system, mental retardation and mental development, up to idiocy and pituitary dwarfism (dwarfism).
• The consequences of autoimmune thyroiditis in pregnant women can result in signs of gestosis, placental insufficiency and early termination of pregnancy.

Autoimmune thyroiditis cannot be completely cured. The patient will have to depend on supportive care for life. Timely diagnosis and correctly selected treatment will provide full life and get rid of possible complications. Save reproductive functions And physical activity, will help achieve stable and long-term remission for many years.

Thyroiditis of the thyroid gland is very common. In terms of prevalence, this disorder ranks second after diabetes mellitus among endocrine system abnormalities. Autoimmune thyroiditis is the most frequent violation from this group. The first symptoms of the disease should encourage a person to consult a doctor who will select effective treatment. So what is thyroiditis?

Thyroiditis is an inflammation of the thyroid gland, which manifests itself in the form of pressure, pain in the neck, difficulty swallowing, and hoarseness. In acute inflammatory process there is a risk of an abscess.

As the anomaly develops, there is a risk of diffuse damage to the organ. First, hyperthyroidism occurs, then hypothyroidism develops. These diseases require adequate therapy.

The basis of chronic and acute thyroiditis is various mechanisms. However key role plays the appearance of inflammation that affects thyroid tissue. The general group is divided into several collective categories, which are characterized by the main types of illness:

1. Acute form of thyroiditis. In this case, purulent thyroiditis or a non-purulent form of the pathology may be observed. However, the disease is often characterized by the appearance of local inflammatory foci in the tissues of the thyroid gland.
2. Subacute thyroiditis of the thyroid gland. The main symptom of this type is considered to be focal organ damage, which has a long development.
3. Chronic thyroiditis of the thyroid. In this case, the provoking factors may be specific pathogens that lead to the development of the disease. These include syphilis and tuberculosis bacillus. Autoimmune thyroiditis may also occur.

Causes

Factors include any causes that lead to damage to the thyroid gland. The only exception is autoimmune thyroiditis, which has a different development mechanism. The main reasons include:

1. Transferred traumatic lesions organ. They can lead to hemorrhage in the gland tissue. The causes and characteristics of the injury are not particularly important.
2. Prolonged exposure to ionizing radiation. This may be due to the person's profession.
3. Viral infections. The development of acute thyroiditis is especially often associated with influenza, mumps or measles.
4. Damage to the follicles that are located in the structure of the gland. This process is the result of the action of antibodies, which have different structures. This reason usually provokes autoimmune thyroiditis of a chronic nature.
5. Bacterial microorganisms that become pathogens.
6. Development of lymphoid infiltration. This causes gradual damage to the organ parenchyma. As a result, chronic lymphocytic thyroiditis develops.