Clinico-etiological profile and it's radiological correlation in patients with hypothyroidism

Background and Objectives: Hypothyroidism is a common but underdiagnosed disorder because of its nonspecific clinical presentation. The study was done to determine the etiological and clinical profile of the patients with hypothyroidism. METHODS A hospital based descriptive study was conducted in Department of Internal Medicine, Guru Gobind Singh Medical College and Hospital, Faridkot where 120 patients of age>=18 years diagnosed as new cases of hypothyroidism and willing to give blood samples were included. They underwent thyroid ultrasound and nuclear scan and/or FNAC wherever required. HAMD scores were measured for all patients to determine the association of depression and its symptoms with hypothyroidism. Results: The mean age of the study patients were 43.37 ± 14.6 years with majority of the population (23.33%) in the age group of 41-50 years. The gender distribution showed female predominance with 85% females and 15% males. Primary thyroid disease were seen in majority 98(81.67%) patients, subclinical hypothyroidism was present in 20(16.67%) cases and 2 cases were of secondary hypothyroidism. Anti TPO and Anti TG antibodies were assessed where 48 cases (40%) and 12 cases (10%) were positive for them respectively. On USG we found that in majority 86(71.67%) of patients, USG neck finding was normal followed by diffusely bulky thyroid in 27(22.50%), solitary nodule in 6(5.00%) cases and single showing lingual thyroid. The radionucleotide uptake scans showed significant association with USG findings (p<0.0001) USG findings were significantly associated with thyroid antibodies (p<0.0001) such that Anti TPO antibodies(IU/mL) was positive in 100% of patients with bulky thyroid and Anti Tg antibody(IU/mL) was positive in 40.74% of patients with bulky thyroid. In our study on thyroid FNAC, 86(71.67%) were normal, 28(23.33%) had lymphocytic thyroiditis, 1 case had colloid nodule and 5(4.17%) cases were malignant. The findings of FNAC showed significant association with radionuclear scans as the uptake was decreased in malignant cases and lymphocytic thyroiditis. Conclusion: Hypothyroidism in increasing mainly among female population with rising autoimmune phenomena. The investigations comprising of thyroid profile, USG and FNAC holds importance for the diagnostic workup of the patients.