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Tiroidite linfocítica e neoplasias : que associações existem?
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Resumo(s)
As tiroidites autoimunes são distúrbios muito comuns e clinicamente significativos na população mundial. A tiroidite linfocítica crónica é uma tiroidite de etiologia autoimune, sendo a causa mais comum de hipotiroidismo nos países em que não há deficiência dietética de iodo. É uma doença multifatorial, para a qual contribuem fatores genéticos, ambientais e endógenos, que levam ao início do processo de agressão autoimune. A tiroidite linfocítica crónica tem sido associada a várias neoplasias, e têm sido desenvolvidos vários estudos, numa tentativa de esclarecer a relação entre as duas patologias. As neoplasias que têm sido associadas à tiroidite linfocítica crónica são: o carcinoma papilar da tiroide, o linfoma MALT da tiroide, o carcinoma da mama e o carcinoma colorretal. Ao longo dos anos, têm sido propostos mecanismos fisiopatológicos comuns, que podem explicar a possível correlação entre estas patologias. Com este trabalho pretende-se a revisão bibliográfica das várias patologias, abordando, em cada uma, a definição, fisiopatologia, epidemiologia, factores de risco, apresentação clínica e tratamento, bem como uma revisão da bibliografia recente da associação entre a tiroidite linfocítica crónica e neoplasias, incluindo possíveis mecanismos fisiopatológicos subjacentes.
Autoimmune thyroiditis is a very common and clinically significant disorder worldwide. Chronic lymphocytic thyroiditis is a thyroiditis of autoimmune etiology, being the most common cause of hypothyroidism in countries where there is no dietary deficiency of iodine. It is a multifactorial disease, to which genetic, environmental and endogenous factors contribute, leading to the beginning of the process of autoimmune aggression. Chronic lymphocytic thyroiditis has been associated with several neoplasms, and several studies have been developed in an attempt to clarify the relationship between the two pathologies. Neoplasms that have been associated with chronic lymphocytic thyroiditis are thyroid papillary carcinoma, thyroid MALT lymphoma, breast and colorectal cancers. Over the years, common pathophysiological mechanisms have been proposed, which may explain the association. This paper aims to review the literature on the various pathologies, addressing the definition, pathophysiology, epidemiology, risk factors, clinical presentation and treatment, as well as a review of the recent literature on the association between chronic lymphocytic thyroiditis and cancer, including possible underlying pathophysiological mechanisms.
Autoimmune thyroiditis is a very common and clinically significant disorder worldwide. Chronic lymphocytic thyroiditis is a thyroiditis of autoimmune etiology, being the most common cause of hypothyroidism in countries where there is no dietary deficiency of iodine. It is a multifactorial disease, to which genetic, environmental and endogenous factors contribute, leading to the beginning of the process of autoimmune aggression. Chronic lymphocytic thyroiditis has been associated with several neoplasms, and several studies have been developed in an attempt to clarify the relationship between the two pathologies. Neoplasms that have been associated with chronic lymphocytic thyroiditis are thyroid papillary carcinoma, thyroid MALT lymphoma, breast and colorectal cancers. Over the years, common pathophysiological mechanisms have been proposed, which may explain the association. This paper aims to review the literature on the various pathologies, addressing the definition, pathophysiology, epidemiology, risk factors, clinical presentation and treatment, as well as a review of the recent literature on the association between chronic lymphocytic thyroiditis and cancer, including possible underlying pathophysiological mechanisms.
Descrição
Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2017
Palavras-chave
Tiroidite linfocitica Tiroidite de Hashimoto Neoplasias Tiroide Mama Cólon