Hashimotos' thyroiditis: Epidemiology, pathogenesis, clinic and therapy

Best Pract Res Clin Endocrinol Metab. 2019 Dec;33(6):101367. doi: 10.1016/j.beem.2019.101367. Epub 2019 Nov 26.


Hashimoto's thyroiditis (HT), the most frequent autoimmune thyroid disorders (AITDs), is the leading cause of hypothyroidism in the iodine-sufficient areas of the world. About 20-30% of patients suffers from HT, whose cause is thought to be a combination of genetic susceptibility and environmental factors that causes the loss of immunological tolerance, with a consequent autoimmune attack to the thyroid tissue and appearance of the disease. The pathologic features of lymphocytic infiltration, especially of T cells, and follicular destruction are the histological hallmark of autoimmune thyroiditis (AIT), that lead to gradual atrophy and fibrosis. An important role in the immune-pathogenesis of AITDs is due to chemokines and cytokines. In about 20% of patients, AITDs are associated with other organ specific/systemic autoimmune disorders. Many studies have demonstrated the relationship between papillary thyroid cancer and AITD. The treatment of hypothyroidism, as result of AIT, consists in daily assumption of synthetic levothyroxine.

Keywords: Hashimoto's thyroiditis; autoimmune diseases; autoimmune thyroid disorders; autoimmune thyroiditis; hypothyroidism; levothyroxine.

Publication types

  • Review

MeSH terms

  • Genetic Predisposition to Disease
  • Hashimoto Disease* / diagnosis
  • Hashimoto Disease* / epidemiology
  • Hashimoto Disease* / etiology
  • Hashimoto Disease* / therapy
  • Hormone Replacement Therapy
  • Humans
  • Hypothyroidism / diagnosis
  • Hypothyroidism / epidemiology
  • Hypothyroidism / etiology
  • Hypothyroidism / therapy
  • T-Lymphocytes / immunology
  • Thyroiditis, Autoimmune / diagnosis
  • Thyroiditis, Autoimmune / epidemiology
  • Thyroiditis, Autoimmune / etiology
  • Thyroiditis, Autoimmune / therapy
  • Thyroxine / therapeutic use


  • Thyroxine