Hashimoto's thyroiditis- What's in a name?

Area of Science:

• Endocrinology
• Immunology
• Medical Nomenclature

Background:

• Hashimoto's thyroiditis (HT) is the most prevalent autoimmune endocrine disorder globally.
• Existing literature presents numerous terms for HT, leading to diagnostic ambiguity and varied definitions.
• The term 'thyroiditis' is broadly applied to thyroid status changes during inflammation, not exclusively to HT.

Purpose of the Study:

• To address nomenclature issues surrounding Hashimoto's thyroiditis.
• To propose standardized terminology for autoimmune thyroid conditions.
• To recommend strategies for preventing potential harm from unnecessary thyroid hormone treatment in euthyroid individuals.

Main Methods:

• Review of current literature and nomenclature practices for autoimmune thyroid disorders.
• Analysis of diagnostic parameters and their clinical relevance.
• Evaluation of the implications of current diagnostic and treatment guidelines.

Main Results:

• The eponym 'Hashimoto' should be replaced with 'autoimmune thyroiditis' or 'autoimmune thyroid disease'.
• Contextual specification (e.g., thyroid status, autoantibodies, imaging) is crucial for clear communication.
• Testing asymptomatic euthyroid patients for thyroid autoantibodies or performing imaging may lead to unnecessary treatment.

Conclusions:

• Adopting standardized terminology like 'autoimmune thyroiditis' will improve clarity and communication.
• Adherence to guidelines by avoiding unnecessary tests in asymptomatic euthyroid individuals can prevent iatrogenic harm.
• The term 'disease' should be used cautiously when evidence is based solely on serological or imaging findings.