A study of clinicopathological and etiological profile of goiter at tertiary cate centre in Kumaon region of Uttarakhand

Abstract

Background: Goiter is one of the common manifestations in Uttarakhand region because of iodine deficiency.Objective: This study was undertaken to illustrate the clinicopathological and etiological profile of patients presenting with Goiter at Tertiary Care Hospital in Kumaon Region of Uttarakhand. Materials & methods: This hospital based cross sectional study was done in 121 patients aged >16 years presenting with goiter in Medicine, ENT OPD/ IPD, Dr. Sushila Tiwari Hospital, Haldwani District Nainital between January 2020- September 2021. Clinical features of goiter were observed, relevant investigations were done, and most probable diagnosis was made as to the reason of goiter. Results: In majority (94.21%) of patients, WHO Goiter grade 2 was observed. Majority (69.42%) of patients had hypothyroidism. Only 2.48% patients had hyperthyroidism. On FNAC majority (95.04%) of patients had Bethesda grade II. In 43.80% of patients, fine needle aspiration finding was suggestive of nodular colloid goiter followed by chronic Lymphocytic thyroiditis (27.27%) and simple colloid goiter (16.53%). Most of the cases of benign category had euthyroid or hypothyroid levels. Both cases of malignancy had euthyroid levels. Both cases of follicular neoplasms of thyroid and adenomatoid nodular thyroiditis also had euthyroid levels. (P=0.012). In majority (60.33%) of patients, probable etiology was iodine deficiency followed by Autoimmune/ Hashimoto's Thyroiditis (27.27%). Conclusion: Iodine deficiency is common in the Kumaon region of Uttarakhand leading to most cases of palpable goiter (WHO grade 2). Goiter was more common among females and in third decade of life. Benign nodules were commonest on FNAC with more proportion of hypothyroid levels followed by euthyroid levels.