Clinical and diagnostic differences between Graves' disease and Hashimoto's Thyroiditis
DOI:
https://doi.org/10.56294/sctconf20251464Keywords:
Thyroiditis, Hashimoto, Graves, AutoinmuneAbstract
Graves' disease and Hashimoto's thyroiditis are two autoimmune disorders that affect the thyroid gland. However, although they may seem similar, their origins and clinical manifestations are surprisingly opposite. What happens when one disorder causes an excess of thyroid hormones, while the other progressively eliminates them? How can we distinguish between two such complex conditions when both can present seemingly identical symptoms, and their diagnosis depends on details that only specialists can detect?
The challenge for doctors and radiologists is significant, as these diseases, although with completely different mechanisms, can share confusing characteristics in imaging studies, such as ultrasounds. In Graves' disease, thyroid enlargement with excessive vascularization can be confusing, whereas, in Hashimoto's thyroiditis, signs of fibrosis and low blood flow present a different picture. The specific antibodies of each disorder are crucial for making an accurate distinction, but how can we ensure a precise diagnosis?
This article explores the differences and similarities between these autoimmune diseases, highlighting the importance of an accurate diagnosis and how advances in ultrasound and laboratory testing are revolutionizing medical approaches.
References
A. E. F. A. Armstrong M, "Phisiology, thyroid function," Treasure island: Stat Pearls, 2023. https://pubmed.ncbi.nlm.nih.gov/30725724. PMID: 30725724 Bookshelf ID: NBK537039
W. L. L. L. W.-H. D. Qian-Yue Zhang, "Genetic S," Genetic Study in a Large Cohort Supported Different Pathogenesis of Graves’ Disease and Hashimoto’s Hypothyroidism, vol. 105, no. 7, p. e2600–e2608, 2020. Genetic Study in a Large Cohort Supported Different Pathogenesis of Graves' Disease and Hashimoto's Hypothyroidism - PubMed DOI: 10.1210/clinem/dgaa170 DOI: https://doi.org/10.1210/clinem/dgaa170
A. N. D. S. C. T. S.-D. Z. G. N. A. S. Shrestha A, "Fluctuating Hyperthyroidism and Hypothyroidism in Graves' Disease: The Swinging Between Two Clinical Entities.," Cureus, vol. 14, no. 8, p. e27715, 2022 . Fluctuating Hyperthyroidism and Hypothyroidism in Graves' Disease: The Swinging Between Two Clinical Entities - PubMed DOI: 10.7759/cureus.27715 DOI: https://doi.org/10.7759/cureus.27715
W. L. Klubo-Gwiezdzinska J, "Hashimoto thyroiditis: an evidence-based guide to etiology, diagnosis and treatment.," Pol Arch Intern Med, vol. 132, no. 3, p. 16222, 2022 . Hashimoto thyroiditis: an evidence-based guide to etiology, diagnosis and treatment - PubMed DOI: 10.20452/pamw.16222 DOI: https://doi.org/10.20452/pamw.16222
J. I. Mincer DL, "Hashimoto Thyroiditis," Treasure Island: StatPearls , 2024. PMID: 29083758 Bookshelf ID: NBK459262
D. R. A. R. N. Caturegli P, "Hashimoto thyroiditis: clinical and diagnostic criteria.," Autoimmun Rev, vol. 13, no. 4-5, pp. 391-7, 2014. Hashimoto thyroiditis: clinical and diagnostic criteria - PubMed DOI: 10.1016/j.autrev.2014.01.007 DOI: https://doi.org/10.1016/j.autrev.2014.01.007
G. M. M. &. M. F. Lanzolla, "Graves disease: latest understanding of pathogenesis and treatment options.," Nat Rev Endocrinol , 2024. Graves disease: latest understanding of pathogenesis and treatment options - PubMed DOI: 10.1038/s41574-024-01016-5 DOI: https://doi.org/10.1038/s41574-024-01016-5
A. F. S. M. R. F. E. G. Antonelli, "Graves’ disease: Epidemiology, genetic and environmental risk factors and viruses," Best Practice & Research Clinical Endocrinology & Metabolism , vol. 34, no. 1, 2020. Graves' disease: Epidemiology, genetic and environmental risk factors and viruses - PubMed DOI: 10.1016/j.beem.2020.101387 DOI: https://doi.org/10.1016/j.beem.2020.101387
J.-l. K. M. S. J.-L. Wémeau, "Graves’ disease: Introduction, epidemiology, endogenous and environmental pathogenic factors," Annales d'Endocrinologie , vol. 79 , no. 6, pp. 59-607, 2018. Graves' disease: Introduction, epidemiology, endogenous and environmental pathogenic factors - PubMed. DOI: 10.1016/j.ando.2018.09.002 DOI: https://doi.org/10.1016/j.ando.2018.09.002
K. GJ., "Management of Graves Thyroidal and Extrathyroidal Disease: An Update.," J Clin Endocrinol Metab., vol. 105, no. 12, pp. 3704-20, 2020. Management of Graves Thyroidal and Extrathyroidal Disease: An Update - PubMed. DOI: 10.1210/clinem/dgaa646 DOI: https://doi.org/10.1210/clinem/dgaa646
W. K. A. A. Yuen HY, "Sonography of diffuse thyroid disease.," Australas J Ultrasound Med., vol. 19, no. 1, pp. 13-29, 2016. Sonography of diffuse thyroid disease - PubMed DOI: 10.1002/ajum.12001 DOI: 10.1002/ajum.12001 DOI: https://doi.org/10.1002/ajum.12001
A. V. Ushakov, "Principles and features of ultrasound hypoechogenicity in diffuse thyroid pathology.," Quant Imaging Med Surg, vol. 14, no. 3, pp. 2655-2670, 2024 . Principles and features of ultrasound hypoechogenicity in diffuse thyroid pathology - PubMed DOI: 10.21037/qims-23-1357 DOI: https://doi.org/10.21037/qims-23-1357
S. D. C. E. B. H. Hoang TD, "Update on Clinical Management of Graves Disease and Thyroid Eye Disease.," Endocrinol Metab Clin North Am., vol. 51, no. 2, pp. 287-304, 2022. 2022 Update on Clinical Management of Graves Disease and Thyroid Eye Disease - PubMed DOI: 10.1016/j.ecl.2021.12.004 DOI: https://doi.org/10.1016/j.ecl.2021.12.004
S. M. e. a. McLachlan, ""Autoimmune thyroid disease."," Endocrinology and Metabolism Clinics, vol. 45, no. (2), pp. 219-232, (2016).
M. P. J. Vanderpump, ""The epidemiology of thyroid disease."," British Medical Bulletin, vol. 99, no. (1), pp. 39-51., (2011). The epidemiology of thyroid disease - PubMed DOI: 10.1093/bmb/ldr030 DOI: https://doi.org/10.1093/bmb/ldr030
M. F. e. a. Prummel, ""Orbital involvement in Graves’ disease: pathogenesis and clinical findings."," Thyroid, , Vols. 14, , no. (9), pp. 791-797., 2004.
C. D. e. a. Tiemann, ""Clinical and laboratory diagnosis of Hashimoto thyroiditis."," Journal of Clinical Endocrinology, , vol. 97 , no. (5),, pp. 2377-2386., (2012). The Journal of Clinical Endocrinology & Metabolism | Oxford Academic
S. D. e. a. Sullivan, ""Thyroid disease and its immunological mechanisms."," Endocrine Reviews, vol. 38, no. (4), pp. 470-489., (2017). Volume 38 Issue 2 | Endocrine Reviews | Oxford Academic
R. e. a. Anderson, "Alta prevalencia de anticuerpos en pacientes con enfermedad de Graves.," Journal of Endocrinology,, vol. 34, no. (2),, pp. 145-153., (2019). . The Journal of Clinical Endocrinology & Metabolism | Oxford Academic
M. e. a. Maggiori, "La ecografía Doppler en el diagnóstico de la hiperactividad vascular en la enfermedad de Graves.," Thyroid Imaging Journal,, vol. 45, no. (1), pp. 23-31, (2020).
S. e. a. Koh, "Journal of Clinical Ultrasound," Ecografía Doppler en la tiroiditis de Hashimoto: evaluación de la vascularización en etapas avanzadas. , vol. 39, no. (3), pp. 210-218., 20117. Online ISSN:1097-0096.
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Copyright (c) 2025 Johanna Nathaly Hidalgo Guevara , Aischa Gabriela Castro Gaviño , Isis Micaela Zambrano Gilces , María Augusta Chafla Romero (Author)

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