Hashimoto's thyroiditis: Countrywide screening of goitrous healthy young girls in postiodization phase in India

Countrywide salt iodization, to prevent nutritional iodine deficiency, has been achieved in India recently. The current study was planned to evaluate the prevalence of goiter and thyroid autoimmunity and assess thyroid functi onal status in a cohort of 6283 healthy schoolgirls from different parts of the country in the postiodization phase. Goitrous girls (n = 1810; 28% of subjects) were investigated for serum T-4 and TSH, antithyroid microsomal a ntibody (TMA) and antithyroglobulin antibody (TGA), urinary iodine excretio n, and cytomorphology by fine-needle aspiration cytology (FNAC). FNAC carri ed out successfully in 764 goitrous girls revealed juvenile autoimmune thyr oiditis (JAT) in 58 (7.5%), which included Hashimoto's thyroiditis in 43 (5 .6%) and focal lymphocytic thyroiditis in 15 (1.9%). TMA and TGA estimated in 722 goitrous girls detected significantly positive titers of TMA (greate r than or equal to 1:1600) and TGA (greater than or equal to 1:160) in 52 ( 7.2%) and 4 (0.55%) girls, respectively. Only 29 (67.4%) girls with Hashimo to's thyroiditis were TMA positive. In patients with FNAC-proven JAT, overt clinical and biochemical hypothyroi dism was seen in three (6.5%) and subclinical hypothyroidism in seven (15%) . Subclinical hyperthyroidism was detected in 5.1% cases of JAT, and none h ad overt hyperthyroidism. No definite correlation was seen between urinary iodine excretion and thyroid autoimmunity.