Clinical, laboratory, ultrasound and FNAB aspects of subclinical thyroid diseases (hypo and hyperthyroidism)

Abstract

The thyroid gland is the first gland to appear in the human embryo and is one of the largest glands in the human body, weighing 15 to 20 grams during adult life, containing two lobes 2 to 2.5 cm3 in volume and about 3 million follicles of various sizes. Hypothyroidism is the syndrome induced by thyroid hormone (TH) deficiency and by increased levels of TSH and of thyroid antibody titers (anti-thyroperoxidase and/or anti-thyroglobulin) and is associated with Hashimoto’s thyroiditis. Hyperthyroidism is the syndrome caused by excess TH, suppression of TSH, increased levels of antithyroid antibodies (antithyroperoxidase, anti-thyroglobulin and anti-TSH receptor) and is associated with Graves’ disease. Subclinical thyroid dysfunctions are characterized by normal TH levels and altered (increased or decreased) TSH levels. They are highly prevalent in the general population and their significance and the need for drug treatment are topics of debate in clinical practice. The present study about Subclinical Hypo and Hyperthyroidism involved younger as well as older women who, on average, were younger than men. The number of men was smaller and men had worse TSH, T4L, T3L, Anti Tg and TRAB values than women. This fact suggests that thyroid diseases are less common among men, although subclinical thyroid disease is more marked and more compromising for this gland among them. Female patients had a higher number of thyroid nodules, but all nodules of both female and male patients were benign. No other systemic involvement was observed in the patients studied, except for the presence of diffuse or nodular goiter (single or multiple), with a predominance of this finding among women. The present study evaluated and compared the clinical and laboratory data of two distinct populations with Hypothyroidism and Subclinical Hyperthyroidism, respectively.