Are sonographic characteristics of Hashimoto's thyroiditis related with immunologic parameters? A cross-sectional study.
Level 4 - case-series / case-control
Cross-sectional observational study
PubMed 38245884 · doi:10.1007/s40618-023-02286-y
What was done
A cross-sectional study investigated the relationship between thyroid ultrasound characteristics and immunologic parameters in 100 consecutive patients (88 female, 12 male) diagnosed with Hashimoto's thyroiditis. Ultrasonography evaluated parenchymal heterogeneity (mild vs. moderate-to-high), extent of fibrosis (none-to-mild vs. moderate-to-high), and thyroid volume (atrophic vs. non-atrophic). Immunologic measurements included thyroid autoantibodies (anti-TPO, anti-Tg), total IgG, IgG4 levels, IgG4/IgG ratio, and lymphocyte subsets, alongside weekly levothyroxine dose.
What was found
The IgG4/IgG ratio and weekly levothyroxine dose were significantly higher in patients with moderate-to-high parenchymal heterogeneity compared to mild heterogeneity (p = 0.043 and p < 0.001, respectively). Patients with moderate-to-high fibrosis had significantly higher anti-TPO, IgG4, IgG4/IgG ratio, and levothyroxine doses compared to those with none-to-mild fibrosis. Anti-TPO and total IgG levels were significantly lower in patients with atrophic thyroids compared to non-atrophic thyroids. The abstract notes a moderate positive correlation between fibrosis and anti-TPO, but does not report exact numerical correlation coefficients, point estimates, or confidence intervals.
Why it matters
These findings suggest that specific sonographic features—particularly fibrosis and marked heterogeneity—reflect distinct immunological activity and correlate with clinical disease severity requiring higher hormone replacement in Hashimoto's thyroiditis.
Limits
The cross-sectional design cannot establish causality or determine whether ultrasound changes precede or follow immunological shifts. The sample size is modest (n = 100) from a single cohort, and the abstract omits specific numerical values, effect sizes, and p-values for several stated correlations.
Cited by
- supports Hashimoto's thyroiditis causes the thyroid gland to appear jagged and smaller on ultrasound imaging.