- Commonest cause of non endemic goitre (endemic is iodine deficiency).
- Autoimmune destructive thyroiditis → Hypothyroidism.
Demographics
- Aged 45-65y
- Females (10-20:1)
- any age, sex, even children!
Aetiology
- Genetic: DR3,5, CTLA4, PTPN22 (TCell mutations)
- Environmental: Viral?
- Auto Immune: TSI, ATG Ab, ATP, AMAb,
Pathogenesis
3 types of damage (all induced by lymphocytes)
- T cell mediated cytotoxicity
- Thryrocyte injury
- antibody dependant cell mediated cytotoxicity