Differentiating Hashimoto's thyroiditis from other diseases

Hashimoto's thyroiditis Microchapters
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Differentiating Hashimoto's Thyroiditis from other Diseases

• Lymphoma and depression may present similarly to Hashimoto's thyroiditis.

Conditions	Causes	Age at onset	Pathological findings	Diagnostic approach
Hashimoto's thyroiditis	Autoimmune	All ages, peak at 30-50	Lymphocytic infiltration Germinal centers Fibrosis (in some variants)	Increased TSH (hypothyroidism) TPO antibodies present in high titer Usually decreased I-123 uptake
Painful subacute thyroiditis	Unknown	20-60	Giant cells Granulomas	Increased TSH (hypothyroidism) and/or Decreased TSH (Thyrotoxicosis) TPO antibodies absent or very low titer I-123 uptake decreased
Riedels thyroiditis	Unknown	30-60	Dense fibrosis	Normal TSH (euthyroidism) TPO antibodies present I-123 uptake decreased or normal
Suppurative thyroiditis	Infection	Children, 20-40	Abscess formation	Normal TSH (euthyroidism) TPO antibodies absent I-123 uptake normal