Clinical profile of cytology confirmed chronic autoimmune thyroiditis: a cohort study

Abstract

Introduction: Chronic autoimmune thyroiditis is one of the thyroid diseases commonly encountered in surgical practice. The incidence of chronic autoimmune thyroiditis is reported as 6.51 and 6.6% in Sri Lanka and worldwide, respectively. Depending on the disease presentation, investigation findings and extent of gland involvement, treatment options range from medical therapy alone to surgical resection of the gland. Methods: This descriptive study was carried out in patients in surgical clinic of a tertiary care centre in Sri Lanka over the span from 2009 to 2022. The objective of this study was to analyze the socio-demographical and clinic-pathological factors in the study group. Results: A total of 93 patients were included in this study. The mean age was 39.63±13.63 years (13–69 years). Majority of them were female (92.5%). Painless neck lump was the commonest presentation (87.1%) while 9.6% of patients presented with painful neck lump. Few of them presented with neck lump associated with voice changes (1.1%) and neck lump associated with musculoskeletal pain (2.2%). Thyroid morphology and thyroid functional status of these patients at initial presentation varied widely. This study revealed that 54.8% had diffuse goiter and 83.87% had hypothyroidism. Of the 22 patients (23.6%) managed with thyroidectomy, 3 of them (3.2%) had thyroid malignancy. Conclusion: Understanding the disparate clinic-pathological presentation of patients with this disease entity is important for diagnosis and management. Clinical and ultrasound scan evaluation and surgical management of suspicious goiters can avoid missing an associated thyroid malignancy.