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Hashimoto's thyroiditis (chronic autoimmune lymphocytic thyroiditis, positive anti-TPO an...

Детермінований перегляд YAML-сутності з джерельної бази. Клінічний авторитет лишається за вказаними source ID та статусом клінічного sign-off.

IDRF-AUTOIMMUNE-THYROIDITIS-LYMPHOMA-PREVENTION
ТипТривожна ознака
Статуспереглянуто 2026-05-18 | очікує клінічного підпису
ХворобиDIS-BURKITT DIS-THYROID-PAPILLARY
ДжерелаSRC-NCCN-BCELL-2025 SRC-NCCN-THYROID-2025

Походження тривожної ознаки

ВизначенняHashimoto's thyroiditis (chronic autoimmune lymphocytic thyroiditis, positive anti-TPO and/or anti-thyroglobulin antibodies with diffuse goiter or hypothyroidism) in an individual without a current thyroid malignancy diagnosis. Established risk factor for primary thyroid lymphoma (~67-80x relative risk for thyroid MALT/DLBCL versus general population; absolute incidence still low at ~0.5-3 cases per 100,000 Hashimoto patients per year) and modest elevation of papillary thyroid carcinoma (PTC) risk (~2-3x in some cohorts, attenuated after adjustment for surveillance bias). Long-standing autoimmune inflammation drives both intrathyroidal MALT acquisition and Hashimoto-PTC nodule emergence. Routine TSH monitoring with thyroid ultrasound and FNA of dominant or sonographically suspicious nodules enables early detection. Prevention-persona RedFlag (§20 ratification 2026-05-18, v0.3 chronic-co...
Клінічний напрямinvestigate
Категоріяother

Логіка спрацьовування

{
  "any_of": [
    {
      "finding": "hashimoto_thyroiditis_diagnosis_confirmed",
      "value": true
    },
    {
      "finding": "anti_tpo_antibodies_positive_with_goiter",
      "value": true
    },
    {
      "finding": "anti_thyroglobulin_antibodies_positive_with_goiter",
      "value": true
    }
  ],
  "type": "lab_value"
}

Нотатки

v0.3 chronic-condition prevention pilot — autoimmune thyroiditis (Hashimoto's). Prevention-persona RedFlag (CHARTER §3 amended 2026-05-18 Path A, HCP-mediated). Fires when patient profile shows confirmed Hashimoto's thyroiditis AND no confirmed thyroid malignancy. Engine routes to PreventionPlan with 2 tracks: TSH q6-12mo + thyroid ultrasound q1y with FNA of any dominant or TIRADS-3+ nodule (IND-AUTOIMMUNE-THYROIDITIS-LYMPHOMA-PREVENTION-SURVEILLANCE) as standard; symptom-driven observation with TSH-only follow-up (IND-AUTOIMMUNE-THYROIDITIS-LYMPHOMA-PREVENTION-OBSERVATION) as alternative — clinically below surveillance-best-practice but included per §15.2 C4 and CHARTER §11 patient-autonomy framing. Evidence base: - **Thyroid lymphoma risk in Hashimoto's:** SEER + Mayo cohort pooled analyses estimate 67-80x relative risk for primary thyroid lymphoma in Hashimoto patients (Holm et al. NEJM 1985; Pedersen & Pedersen Histopathology 1996); MALT and DLBCL predominate. Sudden rapid goiter enlargement, new compressive symptoms (dysphagia, hoarseness), or B-symptoms in a known Hashimoto patient must prompt urgent core-needle biopsy. - **PTC risk in Hashimoto's:** debated — some series re...

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