Search Results (230)

Hashimoto thyroiditis (HT) coexists with differentiated thyroid carcinoma (DTC), particularly papillary thyroid carcinoma, in approximately 25% of cases. However, the impact of this association on DTC outcomes remains controversial. The aim of this study was to analyze the influence of Hashimoto thyroiditis on disease-specific survival (DSS) and recurrence-free survival (RFS) in DTC patients. Methods: A retrospective study conducted at our institution between 2007 and 2020 analyzed 707 DTC patients treated with surgery and/or I-131 therapy. Cox proportional hazards regression was used to identify independent predictors, including sex, age, tumor histology, HT status, and initial TNM stage. Results: Among 707 DTC patients, 628 (88.8%) had papillary cancer, 582 (82.3%) were female, 395 (55.9%) were <55 years old; HT coexisted in 137 (19.4%) patients. During follow-up, 23 (3.25%) developed recurrent disease; at last follow-up, 638 (90.2%) were alive. Initial distant metastases (p < 0.001) and higher T stage (p = 0.002) independently predicted worse DSS. For RFS, male sex (p = 0.015), higher T stage (p = 0.018), and lymph node involvement (p = 0.023) independently predicted an increased risk of recurrence. HT was not an independent predictor of DSS (HR 0.97, 95% CI 0.21–4.52; p = 0.964) or recurrence (HR 0.36, 95% CI 0.05–2.73; p = 0.322). Conclusions: Although Hashimoto thyroiditis was associated with favorable clinicopathological features, it was not independently associated with disease-specific or recurrence-free survival. Conventional staging parameters, particularly tumor stage, remain the principal determinants of prognosis in differentiated thyroid cancer. Full article

Hashimoto’s thyroiditis (HT) is one of the most common autoimmune disorders with a complex etiology and pathogenesis, representing a significant challenge for medicine. Current pharmacological management of HT focuses on the treatment of hypothyroidism rather than addressing the underlying cause. Available scientific evidence provides limited and inconsistent data regarding the association between levothyroxine (L–T4), its dosage, and the levels of antibodies against thyroid peroxidase (anti–TPO) and thyroglobulin (anti–TG) in women with HT. Therefore, the aim of the study was to summarize current findings in this field. This narrative review was conducted using elements of the PRISMA 2020 guidelines. Literature analysis was performed using EMBASE, SCOPUS, and PUBMED databases. Articles published within the last 20 years were included. The search terms included “Hashimoto’s thyroiditis”, “Hashimoto’s disease”, “levothyroxine”, “L–thyroxine”, “anti–TPO”, “anti–TG”, “anti–thyroid antibodies”. Furthermore, to obtain a comprehensive overview of the available knowledge, the search terms were combined with “inflammation,” “treatment,” and “pregnancy”. Treatment with levothyroxine may potentially lead to a decrease in the levels of thyroid antibodies, primarily anti–TPO, in hypothyroid women with HT. Nevertheless, the direct effect of L–T4 on anti–thyroid antibody levels remains inconclusive and varies among individuals. Treatment with L–T4 in hypothyroid women with HT was also associated with improved fertility and pregnancy outcomes. The findings summarized in this review may contribute to systematizing current knowledge regarding L–T4 therapy in women with HT and its potential benefits related to fertility. Further clinical studies are required, particularly those addressing the immunological mechanisms of levothyroxine action, which may improve therapeutic precision in HT. Full article

Background: Hashimoto’s thyroiditis (HT) is a chronic autoimmune disorder characterized not only by thyroid dysfunction but also by metabolic disturbances, micronutrient inadequacies, and low-grade inflammation. Composite indices derived from routine laboratory parameters may therefore help capture the broader systemic profile of the disease. This study explored within-cohort associations of immunonutritional indices including the Prognostic Nutritional Index (PNI), Nutritional Risk Index (NRI), and Controlling Nutritional Status (CONUT), and hemogram-derived inflammatory markers including the Neutrophil-to-Lymphocyte Ratio (NLR), Monocyte-to-Lymphocyte Ratio (MLR), Platelet-to-Lymphocyte Ratio (PLR), and Systemic Immune-Inflammation Index (SII), with thyroid function, thyroid autoimmunity, metabolic characteristics, disease duration, and vitamin D status in adults with Hashimoto’s thyroiditis. Methods: This cross-sectional study included 229 adults diagnosed with HT. PNI, NRI, CONUT, and complete blood count-derived inflammatory markers were evaluated in relation to thyroid function, thyroid autoimmunity, disease duration, metabolic characteristics, and vitamin D status. Because most variables were not normally distributed, the main analyses were conducted using non-parametric tests. Correlations were evaluated using Spearman’s rank correlation coefficients. Exploratory regression models were estimated using HC3 heteroscedasticity-consistent robust standard errors, and CRP-based sensitivity analyses were performed by excluding participants with CRP > 10 mg/L. Results: Vitamin D deficiency was highly prevalent and affected 70.3% of the participants. Among the immunonutritional indices, NRI differed significantly according to BMI category and HOMA-defined insulin resistance (both p < 0.001), indicating a closer relationship with metabolic burden. PNI was associated with disease duration (p = 0.009), whereas the inflammatory indices were largely similar across the clinical groupings examined. In exploratory robust regression models, the explanatory power remained modest (R² = 0.066–0.171). PLR showed the most consistent index-related association with TSH, whereas the CONUT–FT3 association observed in the full-sample robust model was not retained after CRP-based sensitivity analysis. Conclusions: Adults with HT in this study showed frequent vitamin D deficiency together with a substantial burden of excess weight and insulin resistance. Routine immunonutritional and inflammatory indices may provide supportive information on within-cohort biochemical and metabolic heterogeneity, but they should not be interpreted as stand-alone diagnostic or prognostic markers. In particular, NRI appeared to reflect metabolic and adiposity-related burden more than nutritional risk alone, while PLR showed the most internally consistent index-related association with TSH. Full article

Background: Increasing evidence suggests that COVID-19 can induce or exacerbate autoimmune disorders, including immune-mediated thyroid dysfunction. The most common autoimmune thyroid diseases are Graves’ disease and Hashimoto’s thyroiditis; the mechanisms by which viral infections like SARS-CoV-2 trigger these diseases are not fully understood. Objectives: This study aims to systematically review published clinical evidence on the presentation, laboratory characteristics, and outcomes of autoimmune thyroid diseases after COVID-19 infection. Methods: The review followed the PRISMA 2020 framework. Scopus, Web of Science, and PubMed were searched for English-language studies between January 2020 and December 2025 using the terms COVID-19, SARS-CoV-2, autoimmune thyroiditis, Graves’ disease, Hashimoto’s thyroiditis, and autoimmune thyroid disease. Results: In total, 46 studies (five cohort studies and 41 case reports/series) involving 3856 patients were analyzed. The findings indicate that a significant increase in TPOAb prevalence occurs post-COVID-19 infection (15.7% vs. 7.7% in controls). New-onset Graves’ disease (GD) post-COVID-19 presented with higher fT3/fT4 ratios and more aggressive thyrotoxicosis compared to non-viral cases. Rare but severe manifestations included thyrotoxic periodic paralysis, Hashimoto’s encephalopathy, and dilated cardiomyopathy. Conclusions: SARS-CoV-2 may act as a trigger for autoimmune thyroid diseases, particularly in moderate-to-severe infections; however, the strength of this association warrants further investigation with controlled prospective data. Standard therapy remains effective, but thyroid function monitoring is advisable during post-COVID-19 recovery. An interdisciplinary approach is essential for early diagnosis and management of systemic complications. Full article

Background: Hashimoto’s thyroiditis (HT) is a common autoimmune disorder characterized by chronic inflammation and metabolic alterations. Mitochondria-derived peptides (MDPs), particularly mitochondrial open-reading frame of the 12S rRNA-c (MOTS-c), have emerged as key regulators of cellular metabolism, insulin sensitivity, oxidative stress, and inflammatory responses. This study aimed to investigate the association between circulating MOTS-c levels and HT and to explore its potential role in thyroid autoimmunity and metabolic regulation. Methods: In this cross-sectional study, patients diagnosed with HT (n: 90) were compared with age- and sex-matched healthy controls (n: 90). Results: A total of 180 participants were included, comprising 90 patients with HT and 90 age- and sex-matched healthy controls. Circulating MOTS-c levels were significantly lower in patients with HT compared to controls (p < 0.001). MOTS-c levels demonstrated significant inverse correlations with body mass index, fasting glucose, HbA1c, HOMA-IR, thyroid-stimulating hormone, C-reactive protein, and thyroid autoantibody levels (all p < 0.05). In subgroup analyses, these associations remained significant within the HT cohort, particularly for HOMA-IR and thyroid autoantibodies. Multivariable regression analysis identified HT (β = −30.04, p < 0.001) and HOMA-IR (β = −0.85, p < 0.001) as independent determinants of reduced circulating MOTS-c levels. Levothyroxine (LT4) use was not associated with significant differences in MOTS-c concentrations. Conclusions: Circulating MOTS-c levels are markedly reduced in patients with HT and are independently associated with insulin resistance and autoimmune burden. These findings suggest that impaired mitochondrial signaling may play a role in the pathophysiology of thyroid autoimmunity and highlight MOTS-c as a promising biomarker linking metabolic dysfunction and immune dysregulation. Full article

Background: Primary thyroid lymphoma (PTL) is a rare malignancy, accounting for less than 5% of thyroid cancers and less than 2% of extranodal lymphomas. It predominantly affects older women and is strongly associated with autoimmune thyroiditis, particularly Hashimoto’s thyroiditis. Diagnosis is often challenging due to non-specific clinical, imaging, and cytological findings, and the role of surgery has progressively shifted from therapeutic to primarily diagnostic. Methods: We conducted a retrospective single-center case series including nine patients treated for PTL between 2015 and 2025 at a tertiary referral endocrine surgery center. An analysis was conducted on clinical presentation, pre-existing thyroid disease, diagnostic work-up, histopathological subtypes, treatment strategies and outcomes. All patients underwent preoperative ultrasound and fine-needle aspiration cytology (FNAC); surgical intervention was performed to confirm cytology results, when cytology was inconclusive or when compressive symptoms were present. Results: The cohort included six females and three males, with a median age of 65.2 years. Four patients had Hashimoto’s thyroiditis and three had multinodular goiter. FNAC was diagnostic or suggestive of lymphoma in three cases only, and surgical biopsy or thyroidectomy for a definitive diagnosis was performed in eight cases. One case started follow-up after cytology and flow cytometry. Histological subtypes were heterogeneous, including diffuse large B-cell lymphoma, Burkitt’s lymphoma, Hodgkin lymphoma, follicular lymphoma, high-grade B-cell lymphoma, and MALT lymphoma. Seven patients received combined chemoimmunotherapy. A complete response was obtained in eight patients, with a minimum follow-up of three years; one patient died of unrelated causes. Conclusions: PTL remains a rare and diagnostically challenging thyroid malignancy. FNAC alone is frequently insufficient, and surgical biopsy retains an important role in cases with high clinical suspicion or compressive symptoms. While surgery has limited therapeutic value, a multidisciplinary approach and timely, tailored treatment are crucial to achieving favorable outcomes. Full article

Background/Objectives: Psoriasis and Hashimoto’s thyroiditis are chronic immune-mediated disorders affecting distinct target organs but sharing overlapping pathogenic mechanisms, including gut dysbiosis, impaired intestinal barrier function, and systemic immune dysregulation. Growing evidence highlights the gut–skin and gut–thyroid axes as important interfaces linking microbial alterations to immune-mediated inflammation. This review aims to synthesize current knowledge on gut microbiota alterations in psoriasis and Hashimoto’s thyroiditis, with particular emphasis on intestinal permeability, immune pathways, and microbiome-derived metabolites. Methods: A narrative review of experimental and human observational studies was conducted to evaluate evidence on gut microbiota composition, intestinal barrier integrity, immune regulation, bile acid metabolism, and dietary influences in psoriasis and Hashimoto’s thyroiditis. The relevant literature examining mechanistic pathways and clinical associations was included. Results: Both conditions are associated with altered gut microbial composition, including reduced abundance of short-chain fatty acid–producing taxa, which may impair epithelial barrier integrity and promote systemic immune activation. Increased intestinal permeability and enhanced Th17-driven inflammatory responses are reported in both diseases. Recent studies suggest that dysregulated bile acid metabolism may influence intestinal permeability and immune balance along the gut–skin–thyroid axis, although direct clinical data remain limited. Dietary patterns, particularly anti-inflammatory and Mediterranean diets, are consistently associated with increased microbial diversity, improved metabolic profiles, and reduced systemic inflammation. However, most human evidence is observational. Conclusions: The gut microbiome represents a potential mechanistic link connecting diet, intestinal barrier function, immune regulation, and organ-specific autoimmunity in psoriasis and Hashimoto’s thyroiditis. While microbiome-targeted interventions show biological plausibility, well-designed, mechanistically informed randomized controlled trials are required to establish causality and clinical relevance. Full article

Background: Celiac disease (CD) is frequently associated with autoimmune disorders such as Hashimoto’s thyroiditis and type 1 diabetes. Endocrine-specific autoantibodies may emerge during the course of CD, but their true prevalence and clinical relevance in children remain unclear. This study evaluated endocrine autoantibodies and inflammatory profiles in pediatric CD to inform a more tailored diagnostic approach. Methods: In this retrospective cross-sectional study, 240 consecutive children referred to a tertiary center for suspected CD and/or autoimmune endocrine disorders were included. CD was diagnosed according to ESPGHAN criteria. Laboratory evaluation comprised blood counts, metabolic parameters, thyroid function tests, thyroid autoantibodies (anti-TPO, anti-Tg), and type 1 diabetes-related autoantibodies (GAD, IA-2, ZnT8). A subgroup of children with CD (n = 28) underwent exploratory multiplex cytokine analysis. Results: Children with CD were slightly older and more often female than controls. Platelet counts were modestly lower in CD, while other hematologic parameters were similar. Thyroid autoimmunity prevalence did not differ significantly (anti-TPO: 2.7% in CD vs. 5.4% in controls; p = 0.348), and antibody titers and TSH levels were comparable. Anti-TPO positivity was associated with older age (p = 0.038), independent of CD status. Islet autoantibodies were similarly distributed between groups. Cytokine levels were not associated with tTG-IgA status; however, girls with CD showed higher IL-2, IL-4, and IL-10 levels than boys (all p < 0.05), with a trend toward higher IL-1α. Conclusions: In this pediatric cohort enriched for immune and endocrine concerns, CD was not linked to increased thyroid or pancreatic autoimmunity. Distinct sex-related differences in inflammatory profiles were observed, suggesting distinct immune patterns in girls with CD. These findings support a clinically driven rather than routine approach to endocrine autoantibody screening and warrant further studies on cytokine-based immune stratification. Full article

Background/Objectives: Excessive sodium (primarily from sodium chloride, NaCl) intake remains one of the leading dietary risk factors associated with hypertension, cardiovascular disease, and other chronic health conditions worldwide. Commercial diet catering services providing ready-to-eat daily meal plans have become increasingly popular and are often perceived as nutritionally balanced; however, analytical evidence regarding their actual salt content remains limited. The aim of this study was to evaluate the NaCl content of daily food rations (DFRs) offered by commercial diet catering services in Poland. Methods: A total of 120 DFRs representing three dietary patterns (Hashimoto diet, DASH diet, and low-carbohydrate diet) were collected from 40 catering providers. Sodium chloride content was determined using the Mohr titration method. Sodium intake values were estimated by conversion from NaCl equivalents to allow comparison with dietary recommendations. Results: The median NaCl content across all analyzed diets was 14.19 g/day (Q1: 10.62 g; Q3: 17.49 g), corresponding to approximately 284% of the World Health Organization recommended maximum intake of 5 g/day of salt. Nearly half of the analyzed DFRs (45.83%) exceeded the recommended intake by more than threefold. Overall, 99.2% of the analyzed DFRs exceeded recommended NaCl intake levels, while 91.9% did not comply with the values declared by manufacturers. DFRs consisting of five meals contained higher NaCl levels than three-meal plans (p < 0.0196); however, this difference may be related to variation in total food mass rather than meal frequency, as the number of meals was confounded with diet type. Conclusions: These findings suggest that commercially prepared diet catering meals may represent a substantial source of dietary NaCl when used as a primary daily food source. Improved nutritional monitoring, clearer nutrient reporting, and quality control of commercially prepared dietary plans may support public health strategies aimed at reducing NaCl intake. Full article

Autoimmune thyroid diseases (AITD) are based on reactivity to thyroid self-antigens, resulting in varying degrees of persistent inflammation and glandular hyperplasia. The aim of this study was to investigate the interplay between angiogenesis, inflammation, and oxidative stress in patients with AITD. The study included patients with AITD, divided into a group with Hashimoto’s thyroiditis (HT) and a group with Graves’ disease (GD), as well as healthy controls. The results showed that subjects with GD had significantly higher concentrations of angiopoietin-2 (Ang-2) compared to those with HT and the healthy controls (p < 0.001). Inflammatory parameters (C-reactive protein (CRP), the systemic inflammatory immune response index (SII), and the CRP/albumin ratio (CRP/alb)) were higher in both AITD groups (p < 0.001). Oxidative stress parameters were more pronounced in AITD, while the activity of antioxidant enzymes was reduced. Ang-2 positively correlated with H₂O₂ (r = 0.394, p = 0.006) and NO (r = 0.519, p = 0.001) in HT, as well as with O₂⁻ (r = 0.232, p = 0.009) and TBARS (r = 0.190, p = 0.038) in GD, while in GD it showed a negative correlation with SOD (r = −0.426, p = 0.012) and CAT (r = −0.534, p = 0.008). Thus, angiogenesis, inflammation, and oxidative stress are interconnected processes in AITD, which may have significance for further understanding of the disease and the development of therapeutic approaches. Full article

Objectives: To characterize the clinical features, corneal topography, and imaging findings of peripheral hypertrophic subepithelial corneal degeneration (PHSCD) in a single-center study and to evaluate potential associations with systemic conditions. Methods: All patients underwent comprehensive ophthalmic examination, anterior segment photography, high-resolution spectral-domain optical coherence tomography (OCT), and corneal topography/tomography. Patient demographics, ocular history, systemic conditions, and corneal parameters were analyzed. Results: Fourteen patients were included in the study (11 females and 3 males). The mean age was 52.6 ± 12.4 years, and the mean best-corrected visual acuity was 0.56 ± 0.23. Five females had Hashimoto’s disease and two had hyperthyroidism. The mean central corneal thickness was 549.4 μm (SD = 71.0 μm), with significant sectoral thickness variations, particularly in the superior-nasal quadrants (SN-IT sector mean difference: 56.4 μm). High-resolution OCT revealed sharply demarcated, hyperreflective fibrosis within the anterior stroma, predominantly in the superior-nasal quadrants, causing corneal flattening with compensatory steepening and astigmatism. Three patients underwent in vivo confocal microscopy, which showed fibrotic acellular tissue adjacent to normal corneal epithelium. Conclusions: PHSCD predominantly affects middle-aged females and presents with characteristic peripheral, subepithelial fibrosis, causing significant corneal thickness variations and astigmatism. The observed association with thyroid disorders, particularly Hashimoto’s disease, suggests a potential immunological component in PHSCD pathogenesis that warrants further investigation. Advanced imaging with OCT and confocal microscopy provides valuable diagnostic information to accurately characterize this rare corneal condition. Full article

Advanced glycation end-products (AGEs) are a variety of endogenous and exogenous substances that play an important role in inflammation, allergies, and autoimmune diseases. AGEs’ pathogenicity, alongside advanced oxidation protein products (AOPPs) and other ligands, lies in their ability to bind the receptor for advanced glycation end-products (RAGE) and trigger pro-inflammatory signaling pathways and cytokine release. The literature reports numerous studies on the role of the AGE-RAGE axis in various allergic conditions, including bronchial asthma, atopic dermatitis, food allergies, and autoimmune diseases such as rheumatoid arthritis, systemic lupus erythematosus, or Hashimoto’s thyroiditis, where the significant role of the AGE–RAGE axis in the immunopathogenesis of both allergic and autoimmune conditions is largely discussed and demonstrated. They suggest promising opportunities for the development of new diagnostic markers and targeted therapeutic strategies. However, further large-scale studies are needed to fully understand this multifaceted pathway and translate these insights into effective clinical interventions. Full article

Background/Objectives: The incidence of inflammatory bowel disease (IBD) is rising worldwide, particularly in Asia, while the highest prevalence remains in North America and Europe. Evidence on the relationship between IBD and the development of autoimmune thyroiditis is limited. This study investigated the association between IBD and a subsequent autoimmune thyroiditis in a large German primary care cohort over a 10-year period. Methods: Patients with IBD were propensity score matched to non-IBD individuals in a 1:5 ratio based on age, sex, index year, and average annual number of physician visits during follow-up. A total of 20,084 IBD patients—including 8791 with Crohn’s disease and 11,293 with ulcerative colitis—and 100,420 matched controls were included. The primary outcome was the cumulative incidence of autoimmune thyroiditis, including Hashimoto’s thyroiditis and Graves’ disease. The association between IBD and autoimmune thyroiditis was evaluated using univariable conditional Cox regression analysis. Results: In the overall cohort, no significant association was found between IBD (Crohn’s disease or ulcerative colitis) and autoimmune thyroiditis (Hashimoto’s or Graves’ disease). However, among patients aged ≥ 65 years, IBD was associated with a significantly increased risk of Graves’ disease (HR 2.83; 95% CI 1.56–5.15), an effect observed in both Crohn’s disease (HR 3.23; 95% CI 1.20–8.69) and ulcerative colitis (HR 2.64; 95% CI 1.25–5.60). Conclusions: While IBD was not associated with autoimmune thyroiditis overall, a significant positive association with Graves’ disease was observed among patients aged ≥ 65 years, highlighting the importance of age-specific risk assessment. Full article

Background: Experimental autoimmune thyroiditis is an important animal model for studying Hashimoto’s thyroiditis. Our aim was to develop the model using CBA/J-DR3 mice expressing human HLA-DR3, which is associated with autoimmune thyroiditis in humans, to better simulate human autoimmune thyroiditis. Such a humanized model can be used to test specific antigen therapies for autoimmune thyroiditis. Methods: CBA/J-DR3 mice were produced by back-crossing B6-DR3 mice to the CBA/J background. Female CBA/J-DR3 mice were immunized with human thyroglobulin (Tg) in complete Freund’s adjuvant on days 0 and 7. On day 21, mice were sacrificed, blood collected, spleen and thyroid harvested for analysis. Splenocytes were analyzed for T cell responses to Tg and its major T-cell epitope in human autoimmune thyroiditis, Tg.2098. Serum anti-thyroglobulin antibodies were measured by ELISA, and thyroid-stimulating hormone was measured using the Luminex assay. Thyroid histology and immunohistochemistry were examined. Results: Immunized CBA/J-DR3 mice showed significant T cell proliferation in response to Tg (stimulation index 3.4 ± 4.5) and Tg.2098 (1.5 ± 0.7). Anti-thyroglobulin antibody levels were elevated in immunized mice when compared to control mice (2.05 ± 0.75 vs. 0.15 ± 0.06, p < 0.0001). T cells demonstrated higher reactivity to thyroid antigens by enhanced production of pro-inflammatory cytokines. Thyroid immunohistochemistry revealed mild CD3-positive T-cell infiltration. Conclusions: This novel humanized CBA/J-DR3 mouse model of Hashimoto’s thyroiditis demonstrates key features of human autoimmune thyroiditis. The HLA-DR3 background and the immune response to Tg and Tg.2098 enhance translational relevance, making this a valuable model for studying thyroid disease pathogenesis and testing targeted immune-modifying therapies. Full article

Primary biliary cholangitis (PBC) is a chronic, cholestatic disease, with a female predominance and a female-to-male ratio of approximately 10:1, that typically follows a slowly progressive, decades-long disease course. The disease is usually asymptomatic at the time of diagnosis and it is not uncommon for a patient to present with cirrhosis. Patients with PBC may also present with extrahepatic manifestations, including pruritus, chronic fatigue, and osteoporosis, while co-existence of other autoimmune diseases, such as autoimmune hepatitis, Hashimoto’s disease, Sjogren’s syndrome, or systemic sclerosis is not uncommon. The exact pathogenesis of PBC remains elusive with a variety of different factors, including genetic, epigenetic, and environmental ones, alongside immune dysregulation leading to a dysfunction of biliary “bicarbonate umbrella”, a protective mechanism by which cholangiocyte-secreted bicarbonate creates an alkaline microenvironment shielding the epithelium from bile acid-induced injury, and increased biliary epithelial cells apoptosis. Full article