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Hashimoto Disease

Definisi
• Hashimoto’s disease is an autoimmune
disorder that can cause hypothyroidism, or
underactive thyroid. With this disease,
your immune system attacks your thyroid. The
thyroid becomes damaged and can’t make
enough thyroid hormones.
Epidemiologi
• Hashimoto’s disease is the most common
cause of hypothyroidism in the United States,
and affects about 5 people out of 100.
Etiologi
• Hashimoto’s disease is at least 8 times more
common in women than men. Although the
disease may occur in teens or young women,
it more often appears between ages 40 and
60.
• Your chance of developing Hashimoto’s
disease increases if other family members
have the disease
• You are more likely to develop Hashimoto’s disease if
you have other autoimmune disorders. Conditions
linked to Hashimoto’s disease include

• Addison’s disease
• autoimmune hepatitis
• celiac disease
• Lupus
• pernicious anemia
• rheumatoid arthritis
• Sjögren’s syndrome
• type 1 diabetes
• vitiligo
Patofisiologi
• In Hashimoto’s disease, your immune system
makes antibodies that attack the thyroid
gland. Large numbers of white blood cells
called lymphocytes, which are part of the
immune system, build up in the thyroid.
Lymphocytes make the antibodies that start
the autoimmune process.
Manifestasi Klinis
• The hypothyroidism of Hashimoto’s disease often is subclinical—mild and
without symptoms—especially early in the disease.

• As hypothyroidism progresses, you may have one or more of the following


symptoms:
– tiredness
– weight gain
– trouble tolerating cold
– joint and muscle pain
– constipation
– dry, thinning hair
– heavy or irregular menstrual periods and problems becoming pregnant
– depression
– memory problems
– a slowed heart rate
Diagnosis
• Your doctor will start with a medical history
and physical exam, and will order one or more
blood tests to find out if you have
hypothyroidism. You may have a goiter, which
is common in Hashimoto’s disease. Your
doctor will order more blood tests to look for
antithyroid antibodies known as
thyroperoxidase antibodies (TPO), which
almost all people with Hashimoto’s disease
have.
Tatalaksana
• Treatment usually depends on whether your thyroid is
damaged enough to cause hypothyroidism. If you don’t
have hypothyroidism, your doctor may choose to
simply monitor you to see if your disease gets worse.

• Hypothyroidism is treated by replacing the hormone


that your own thyroid can no longer make. You will
take levothyroxine, a thyroid hormone medicine that is
identical to a hormone the thyroid normally makes.
Your doctor may recommend that you take the
medicine in the morning before you eat.
• Your doctor will give you a blood test about 6 to 8
weeks after you begin taking thyroid hormone
and adjust your dose if needed. Each time you
change your dose, you’ll have another blood test.
Once you’ve reached a dose that’s working for
you, your doctor will probably repeat the blood
test in 6 months and then once a year.

• Your hypothyroidism most likely can be


completely controlled with thyroid hormone
medicine, as long as you take the prescribed dose
as instructed.
Pencegahan
• The thyroid uses iodine, a mineral in some foods,
to make thyroid hormones. However, people with
Hashimoto’s disease or other types of
autoimmune thyroid disorders may be sensitive
to harmful side effects from iodine.

• Eating foods that have large amounts of iodine—


such as kelp, dulse, or other kinds of seaweed—
may cause hypothyroidism or make it worse.
Sumber
https://www.niddk.nih.gov/health-
information/endocrine-diseases/hashimotos-disease

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