Compared with classic Hashimoto’s thyroiditis, chronic autoimmune serum-negative thyroiditis requires a lower substitution dose of l-thyroxine to correct hypothyroidism

Croce, Laura; Martinis, Luca de; Pinto, Sara; Coperchini, Francesca; Dito, Giorgia; Bendotti, Giulia; Pasquali, Daniela; Cappelli, Carlo; Latrofa, Francesco; Magri, Flavia; Chiovato, Luca; Rotondi, Mario

doi:10.1007/s40618-020-01249-x

Cited by 17 publications

(14 citation statements)

References 29 publications

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“…At present, the common clinical treatment for CLT patients with hypothyroidism is thyroid hormone alternative therapy, which can alleviate a series of clinical symptoms manifested by hypothyroidism. However, there are still some patients who are unable to effectively control the progression of the disease, resulting in increasingly severe symptoms of hypothyroidism [ 7 , 8 ]. More studies have shown [ 9 , 10 ] that selenium deficiency in vivo is closely related to the development of CLT and that selenium plays an important regulatory role in the thyroid antioxidant system and immune disorders.…”

Section: Introductionmentioning

confidence: 99%

Clinical Observation of Levothyroxine Sodium Combined with Selenium in the Treatment of Patients with Chronic Lymphocytic Thyroiditis and Hypothyroidism and the Effects on Thyroid Function, Mood, and Inflammatory Factors

Sun

Zhu

et al. 2021

Evidence-Based Complementary and Alternative Medicine

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The purpose of this study was to investigate the therapeutic effects of levothyroxine sodium combined with selenium treatment and single levothyroxine sodium treatment on patients with chronic lymphocytic thyroiditis and hypothyroidism and to analyze the effects of different treatment regimens on patients’ thyroid function, mood, and inflammatory factors, with the aim of providing a reference for clinical treatment. The subjects of the current study were 138 chronic lymphocytic thyroiditis (CLT) patients with hypothyroidism admitted to our hospital from May 2016 to September 2019 and were randomly divided into a control group taking levothyroxine sodium (LT4) treatment and a combined group of LT4 combined with selenium treatment, with 69 cases each. Patients in both groups were evaluated for efficacy after 3 months of treatment, and their thyroid function was observed by total triiodothyronine (TT3), total thyroxine (TT4), thyroid stimulating hormone (TSH), thyroid peroxidase antibody (TPOAb), and thyroid globulin antibody (TGAb), and their mood changes were observed by Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS) scores. The levels of inflammatory factors such as interleukin-2 (IL-2), interleukin-10 (IL-10), and tumor necrosis factor-α (TNF-α) were measured, and the occurrence of adverse drug reactions during the treatment period was observed and recorded in all patients. The results showed that the total effective rate of the combined group was significantly higher than that of the control group. The levels of TT3, TT4, TSH, TgAb, and TPOAb, SAS and SDS scores, and levels of inflammatory factors such as IL-2, IL-10, and TNF-α were significantly improved in both groups after treatment. Compared with the control group, TGAb, TPOAb, IL-2, TNF-α levels, and SAS and SDS scores decreased more and IL-10 levels increased more in the combined group, while the differences of other indexes were not statistically significant. This suggests that LT4 has certain efficacy in treating CLT with hypothyroidism, and the combined selenium treatment can improve the therapeutic effect of LT4 and can play a greater role in improving patients’ mood and immune and inflammatory responses.

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Section: Introductionmentioning

confidence: 99%

Clinical Observation of Levothyroxine Sodium Combined with Selenium in the Treatment of Patients with Chronic Lymphocytic Thyroiditis and Hypothyroidism and the Effects on Thyroid Function, Mood, and Inflammatory Factors

Sun

Zhu

et al. 2021

Evidence-Based Complementary and Alternative Medicine

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“…This could not rule out the diagnosis of a coexisting Hashimoto's thyroiditis since cases of serum‐negative‐chronic‐autoimmune‐thyroiditis were reported and are considered a milder variant of classic Hashimoto's thyroiditis. 14 However, in our patient, histopathological features of Hashimoto's thyroiditis were not observed either.…”

Section: Discussioncontrasting

confidence: 68%

A diffuse large B‐cell thyroid lymphoma presented as a compressive goiter in a young woman with no evidence of Hashimoto's thyroiditis

Oueslati

Chatti

Yazidi

et al. 2021

Clinical Case Reports

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“…The final study cohort included 510 patients (476 females and 34 males). In detail, 297 (58.2%) patients showed positive tests for both TgAb and TPOAb; 134 (26.3%) patients had only TPO Ab; 44 (8.6%) had only Tg Ab; and 35 (6.9%) patients had negative tests for both Ab and based upon a diffuse hypoechoic pattern of the thyroid at ultrasound were diagnosed with serum negative autoimmune thyroiditis (27,28). Their median (range) age was 49 (19-82 years).…”

Section: Methodsmentioning

confidence: 99%

Patients with chronic autoimmune thyroiditis are not at higher risk for developing clinically overt thyroid cancer: a 10-year follow-up study

Rotondi

Groppelli

Croce

et al. 2020

European Journal of Endocrinology

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Objective The association between chronic autoimmune thyroiditis (CAT) and differentiated thyroid cancer (DTC) remains controversial. The incidence of DTC increases when screening procedures are implemented, as typically occurs in CAT patients being routinely submitted to thyroid Ultrasound (US). The aim of this study was to longitudinally evaluate the long-term development of DTC in patients with CAT. Design and Methods A retrospective longitudinal cohort study was designed. 510 patients with chronic autoimmune thyroiditis (CAT) with a 10-years follow-up were enrolled. Patients were divided in two groups according to the presence (CAT+NOD+; n=115) or absence (CAT+NOD-; n=395) of co-existent nodules at diagnosis. The main outcome measures were appearance of new thyroid-nodules and development of DTC during follow-up. Results: During a 10-years median follow-up period, new thyroid-nodules were detected in 34/115 (29.5%) patients in the CAT+NOD+ group and in 41/395 (10.3%) in the CAT+NOD- group (p<0.001). Logistic regression analysis showed that thyroid-volume at diagnosis and belonging to the CAT+NOD+ group significantly predicted the appearance of a new thyroid nodule during follow-up, independently of baseline age and sex. Among the 75 patients experiencing the appearance of a new nodule, 27 (39%) met the criteria for fine-needle-aspiration-cytology (FNAC). A benign cytological diagnosis was rendered in all cases Conclusions: In our series of CAT patients the appearance of new thyroid-nodules was frequent, but none of them was found to be malignant. The presence of CAT appears to be associated with a negligible risk of developing clinically overt DTC.

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Compared with classic Hashimoto’s thyroiditis, chronic autoimmune serum-negative thyroiditis requires a lower substitution dose of l-thyroxine to correct hypothyroidism

Cited by 17 publications

References 29 publications

Clinical Observation of Levothyroxine Sodium Combined with Selenium in the Treatment of Patients with Chronic Lymphocytic Thyroiditis and Hypothyroidism and the Effects on Thyroid Function, Mood, and Inflammatory Factors

Clinical Observation of Levothyroxine Sodium Combined with Selenium in the Treatment of Patients with Chronic Lymphocytic Thyroiditis and Hypothyroidism and the Effects on Thyroid Function, Mood, and Inflammatory Factors

A diffuse large B‐cell thyroid lymphoma presented as a compressive goiter in a young woman with no evidence of Hashimoto's thyroiditis

Patients with chronic autoimmune thyroiditis are not at higher risk for developing clinically overt thyroid cancer: a 10-year follow-up study

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