CASO CLÍNICO: TIROIDITIS DE HASHIMOTO CON HIPOTIROIDISMO PROGRESIVO EN MUJER JOVEN
- 1. Universidad Libre Seccional Cali, Programa de Medicina Cali; Valle del cauca, Colombia
- 2. Universidad Santiago de Cali, Programa de Medicina Cali; Valle del cauca, Colombia.
Description
La tiroiditis de Hashimoto es la principal causa de hipotiroidismo adquirido en regiones con adecuado consumo de yodo y representa un modelo clásico de autoinmunidad órgano-específica. Se caracteriza por la presencia de autoanticuerpos antitiroideos, infiltrado linfocitario progresivo y destrucción del parénquima tiroideo, lo que conduce al desarrollo de hipotiroidismo clínico si no se identifica y trata de forma oportuna. Se presenta el caso de una mujer de 29 años, previamente sana, con antecedentes familiares de enfermedad autoinmune, que consultó por fatiga persistente, aumento de peso, plenitud cervical y síntomas inespecíficos como estreñimiento, piel seca y caída del cabello. Al examen físico se documentó bocio difuso, piel fría y bradicardia. Los estudios revelaron TSH elevada, T4 libre disminuida y anticuerpos antitiroideos positivos. La ecografía tiroidea mostró glándula aumentada, hipoecoica y heterogénea, mientras que la punción aspirativa confirmó hallazgos compatibles con tiroiditis de Hashimoto. Se inició tratamiento con levotiroxina, logrando mejoría clínica y normalización bioquímica tras 12 semanas. Este caso resalta la importancia de mantener un alto índice de sospecha clínica frente a síntomas inespecíficos en mujeres jóvenes, especialmente con antecedentes familiares de autoinmunidad. El diagnóstico precoz y la reposición hormonal permiten prevenir complicaciones metabólicas, cardiovasculares y reproductivas, favoreciendo la recuperación funcional y la calidad de vida.
Abstract (English)
Hashimoto’s thyroiditis is the leading cause of acquired hypothyroidism in regions with adequate iodine intake and represents a classical model of organ-specific autoimmunity. It is characterized by the presence of antithyroid autoantibodies, progressive lymphocytic infiltration, and destruction of the thyroid parenchyma, ultimately leading to clinical hypothyroidism if not identified and treated in a timely manner. We report the case of a 29-year-old woman, previously healthy, with a family history of autoimmune disease, who presented with persistent fatigue, weight gain, cervical fullness, and nonspecific symptoms such as constipation, dry skin, and hair loss. Physical examination revealed a diffuse, firm, painless goiter, cold skin, and bradycardia. Laboratory tests showed elevated TSH, decreased free T4, and positive antithyroid antibodies. Thyroid ultrasound demonstrated an enlarged, hypoechoic, heterogeneous gland, while fine-needle aspiration confirmed histological features consistent with Hashimoto’s thyroiditis. Levothyroxine therapy was initiated, leading to clinical improvement and biochemical normalization after 12 weeks. This case underscores the importance of maintaining a high index of clinical suspicion in young women with nonspecific constitutional symptoms, particularly in the context of a family history of autoimmunity. Early diagnosis and timely hormone replacement therapy are essential to prevent metabolic, cardiovascular, and reproductive complications, thereby improving functional recovery and quality of life.
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Additional details
Additional titles
- Translated title (English)
- CLINICAL CASE: HASHIMOTO'S THYROIDITIS WITH PROGRESSIVE HYPOTHYROIDISM IN A YOUNG WOMAN
Identifiers
- ISSN
- 2530-5468
Dates
- Submitted
-
2025-08-25
- Accepted
-
2025-10-02
Software
- Repository URL
- https://revistacientificasanum.com/
References
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