HASHIMOTO’S THYROIDITIS, PRESENTING PATTERNS IN SULAIMANI

Background  Hashimoto’s thyroiditis (HT) is a common chronic autoimmune thyroid disease, affecting mostly young and middle-aged females. It causes painless, firm, diffusely enlarged thyroid gland. The clinical presentations and thyroid status are variable. The anti-thyroid autoantibodies and fine-needle aspiration (FNA) cytology with lymphocytic infiltration with Hurthle’s cells are pathognomonic. Objectives  To assess the pattern of Hashimoto’s thyroiditis in Sulaimani city, investigating the patients’ characteristics, clinical presentations, thyroid status and diagnosis and if these are mosaic, i.e. a mess or proper and organized like Messi. Patients and Methods A cross-sectional, descriptive study was carried out in Sulaimani Teaching Hospital, Iraq, from October 2014, to October 2015. The study enrolled eighty patients with Hashimoto’s thyroiditis. Results The mean age of the patients was 36.7 years. There was only one male patient. Only a quarter of patients had weight gain, but more than that (30%) had weight loss. The firmly diffuse enlarged gland was found in 64 (80%) patients. Over one-third of patients (36.25%) had high ESR. The majority (92.5%) had high anti-thyroid peroxidase antibodies. Variable thyroid status was detected, slightly over half of them were hypothyroid, 30 (37.5%) patients had euthyroid status, and 7 (8.75%) were in hyperthyroid status. Ultrasound scan revealed; hypo-echogenicity (87.5%), enlarged thyroid gland (82.5%), increased vascularity (52.5%) and psuedonodules in (85%) of the patients. Seventy-six patients (95%) had lymphocytic infiltration, and 58 (72.5%) had Hürthle cells.  Conclusion Hashimoto’s thyroiditis has variable clinical presentations and thyroid status, but it causes: Hypothyroidism, it is an Autoimmune disease, mainly affect women (sex distribution), of Middle age, with Enlarged thyroid gland, with characteristics ultrasound Scan findings, with raised Serum antibodies and characteristic lymphocytic cell Infiltration, therefore, HAS MESSI.