clinical features

Last reviewed 01/2018

Classically, presentation is with a goitre or hypothyroidism or both.

The thyroid may be barely palpable or greatly enlarged. Characteristically, it is firm, and well defined with an enlarged pyramidal lobe and palpable neighbouring lymph nodes. Enlargement is usually slow and painless but rarely, may be more rapid and painful.

At presentation, 75% of patients are euthyroid, 20% are hypothyroid, and 5% are hyperthyroid - a disease known as hashitoxicosis. About 50% eventually become hypothyroid because of destruction of the thyroid gland.

There appears to be an increased incidence of lymphoma but not of thyroid carcinoma.


  • Chapel, H. Essentials of Clinical Immunology 2014. Wiley
  • Robbins and Cotran (2010). Pathologic Basis of disease. Saunders.