Clinical Course

Abstract

The various clinical presentations of Hashimoto's thyroiditis (HT) include euthyroidism and goiter, subclinical hypothyroidism and goiter, primary thyroid failure, hypothyroidism, adolescent goiter, painless thyroiditis or silent thyroiditis, post-partum painless thyrotoxicosis, and alternating hypo- and hyper-thyroidism. Generally, the progress from euthyroidism to hypothyroidism is considered “irreversible” due to thyroid cell damage and loss of thyroidal iodine stores. Myxedema psychosis is a relatively uncommon consequence of hypothyroidism. Myxedema coma, a rare, life-threatening condition, occurs late in the progression of hypothyroidism when the body's compensatory responses to hypothyroidism are overwhelmed by a precipitating factor such as infection, medication, environmental exposure, or other metabolic-related stresses. Several unusual syndromes that are believed to be associated with HT include amyloidosis, interstitial pneumonitis, Vitiligo, hives, and alopecia. Hashimoto's encephalopathy and Hashimoto's ophthalmopathy are rare complications of HT. This chapter explores the clinical course of Hashimoto's disease.