Immunological and clinical characterization of patients with untreated euthyroid and hypothyroid autoimmune thyroiditis. Antibody spectrum, response to TRH and clinical study

Abstract

In a region of endemic goitres, 200 untreated patients in whom thyroid microsomal (MCHA) and/or thyroglobulin (TGHA) antibodies have been detected were analyzed and other organ specific autoantibodies were tested. Thyroid function was assessed by a TRH test in all of them. Patients with previous thyroid disease and patients with clinical or biochemical signs of thyrotoxicosis were excluded.In 58 (29%) of the patients diseases coexisted in which a high incidence of autoimmune reactions has been recognized. In the absence of the corresponding clinical disease, 13.7% of the patients had antibodies to parietal cells of the stomach, 3.1% had antibodies to adrenal cortex, 1% to steroid producing gonadal cells, 1% to pancreatic islet cells, and 0.5% of the patients had antibodies to striated muscle fibrils. The incidence of associated organ-specific autoantibodies was no higher in patients with hypothyroidism (36.4%) compared with patients who had a normal thyroid function (27.9%). The determination of a 'significant' thyroid antibody titre is discussed.In 24.5% of the 200 patients a form of hypothyroidism was recognized. Fifty of the patients with TGHA titres \m=ge\6400, and 56.2% of those with MCHA \m=ge\102400 were hypothyroid. Patients with such titres of thyroid antibodies should be examined and followed up. Patients with associated islet cell or adrenal antibodies should be reinvestigated and followed up observing their glucose tolerance and adrenocortical function, respectively. Autoimmune thyroid disease implies a great spec¬ trum of clinical conditions, including (goitrous) Hashimoto's disease, primary myxoedema, and

Thyroiditis in Mosul: a clinico-pathological study

“…Clinically, the majority of the patients (80%) were euthyroid at presentation. This is similar to the findings observed by others (1,2,3,6,(11)(12)(13)(14)(15) , and is consistent with the usual clinical course of H.T. where thyroid function progresses from overactive to normal and ending up in hypothyroid state (1,2,3) .…”

Clustering of additional autoimmunity behaves differently in Hashimoto's patients compared with Graves' patients

“…In thyroid patients (Graves' disease or Hashimoto's disease), the frequency of adrenal antibodies has been reported to be around 2-3% (13)(14)(15). Studies comparing additional autoimmunity in Graves' and Hashimoto's disease in sufficient numbers of patients Table 2 Additional autoimmunity (adrenal, b-cell, celiac, gastric and 'other') in Graves' (nZ523) and Hashimoto's (nZ359) disease patients.…”

Ultrasonography related to clinical and laboratory findings in lymphocytic thyroiditis

“…Our data clearly sustain the assumption that serum findings only incompletely reflect thyroid status. (10)(11)(12)(13)19). The prevalence of hypothyroidism in elderly people based on elevated TSH serum levels varies between 0.5-6% (20,21).…”