Current State of the Autoimmune Thyroiditis Problem

Abstract

The review provides up-to-date data on pathogenetic mechanisms, opportunities of diagnosis, and organizational and medical measures concerning autoimmune thyroiditis (AIT). AIT is a polyetiological disease which is mainly caused by environmental factors, genetic predisposition and disorder in immune regulation. Primary AIT incidence in the Republic of Belarus in 2017 is 58 cases per 100,000 population in the overall structure of the thyroid gland pathology, the AIT accounts for up to 40 %. The upward trend in the number of autoimmune diseases of the thyroid gland, including that in ecologically unfavorable regions, is explained not only by the true increase in the number of patients with AIT, the consequences of stress, but also by the overdiagnosis. There is contradictory data on the correlation of the level of iodine sufficiency of the population with the AIT development; there is no convincing evidence of the role of radiation factors in increasing the risk of AIT. The review analyzes the correlation of AIT with an imbalance in a number of microelements involved in the synthesis of thyroid hormones and affecting the iodine exchange. The article presents the study results that determined the nature of immune disorders in AIT and hypothyroidism in such forms as disorders of lymphocyte subpopulations, proinflammatory and anti-inflammatory cytokines, changes in the apoptosis mechanisms, which were proposed for use as predictors of the severity of thyroid immune inflammation and hypothyroidism. The criteria for selecting patients with an increased risk of developing AIT complications remain unclear, that necessitates the development and implementation of additional organizational and medical measures for following-up of such patients and assessing their quality of life.