CLINICAL, BIOCHEMICAL, CYTOLOGICAL, AND ULTRASONOGRAPHIC SPECTRUM OF AUTOIMMUNE THYROIDITIS: EXPERIENCE FROM A TERTIARY CARE CENTRE

Abstract

Background: Autoimmune thyroiditis (AIT) is the most common organ-specific autoimmune disorder characterized by chronic immune-mediated destruction of thyroid follicles, resulting in progressive thyroid dysfunction. Hashimoto's thyroiditis represents the predominant form of AIT and is diagnosed through a combination of clinical manifestations, thyroid function tests, thyroid autoantibody estimation, fine needle aspiration cytology (FNAC), and ultrasonography. Aim: To evaluate the clinical, biochemical, cytological, and ultrasonographic characteristics of patients diagnosed with autoimmune thyroiditis attending a tertiary care hospital. Materials and Methods: A retrospective cross-sectional study was conducted among 420 patients with autoimmune thyroiditis in the Department of General Surgery, Shija Academy of Health Sciences, Manipur (India). Clinical records, thyroid function parameters, thyroid autoantibody profiles, FNAC findings, and ultrasonographic reports were reviewed. Descriptive and inferential statistical analyses were performed to assess the clinicopathological and radiological presentations of the disease. Findings: The study demonstrated a marked female predominance among patients with autoimmune thyroiditis. Thyroid functional status ranged from euthyroidism to subclinical and overt hypothyroidism, with elevated thyroid-stimulating hormone (TSH) being the most frequent biochemical abnormality. Anti-thyroid peroxidase (Anti-TPO) antibodies were positive in a substantial proportion of patients, confirming autoimmune thyroid involvement. Cytological examination predominantly revealed diffuse lymphocytic infiltration with varying degrees of Hurthle cell metaplasia, while ultrasonography commonly demonstrated diffuse hypoechogenicity and heterogeneous thyroid echotexture, consistent with chronic autoimmune thyroiditis. Conclusion: Autoimmune thyroiditis exhibits diverse clinical, biochemical, cytological, and ultrasonographic manifestations. The combined assessment of thyroid function tests, thyroid autoantibodies, FNAC, and ultrasonography offers a comprehensive and reliable diagnostic approach for the early detection and characterization of autoimmune thyroiditis, thereby facilitating timely clinical management and improved patient outcomes.