Thyroid glands involvement in advanced Acquired Immunodeficiency Syndrome (AIDS): An autopsy-based study

Abstract

Objective: The course of HIV infection and the AIDS can be complicated by a variety of endocrine abnormalities. The aim of this study was to assess the frequency and the major histopathological characteristics of thyroid involvement in autopsy of patients with AIDS. Method: The thyroid were obtained from 60 patients with AIDS that were autopsied in the Death Verification Service of the Capital, Faculty of Medicine, University of São Paulo (SVOC-FMUSP) between 1996 and 1999, from a time before the use of highly active antiretroviral regimens. Results: The anatomopathological lesions detected in 23 glands (38.3 %) were colloid goiter (52.2 %); colloid goiter+ follicular hyperplasia (8.7 %); follicularhyperplasia (4.3%); thyroiditis lymphocytic cronic (8.7 %); papilary carcinoma (4.3 %); cryptococcosis (4.3 %); tuberculosis (8.7 %); epithelioids granulomas (8.7 %) which were negatives for Ziehl-Neelsen staining. Although thyroid disease had not been clinically diagnosed, its involvement was significant and in 3 cases (13 %) it was related to the immunodeficiency, with Mycobacterium tuberculosis being the most common opportunistic agents. Conclusion: Thyroid lesions are not uncommon in AIDS patients, occurring over a third of the patients studied. Thus, the analysis of the thyroid from autopsies of patients with AIDS can help identify most frequent lesions and help in early diagnosis and appropriate treatment for these diseases.