Thyroid vascularization is an important ultrasonographic parameter in untreated Graves’ disease patients

Abstract

Graves’ disease is characterized by two sonographic features, hypoechogenicity and increased blood flow. The aim of this study was to review retrospectively ultrasound features and biochemical data of a cohort of untreated Graves’ disease patients. We reviewed charts of 42 such patients, who were referred to our Endocrinology Unit from January 2013 to May 2018. One operator performed all the thyroid sonographic scans. Serum TSH, FT3, FT4 and TSH-receptor antibodies (TRAb) levels at the time of ultrasound examination were evaluated. Over a mean follow-up of 30.9 months, about one in three patients (38%) experienced at least one recurrence of hyperthyroidism (1.4 ± 0.6 recurrence per patient), either on or off antithyroid drugs. We found that thyroid vascularization correlated directly with thyroid volume and that larger thyroids tended to be more vascularized. We also found that greater vascularization was associated with marked hypoechogenicity, and greater FT4 and TRAb levels. Patients who experienced recurrence(s) had 1.7-fold higher levels of TRAb at onset. In conclusion, thyroid hypervascularization at onset of Graves’ disease is an important sonographic feature.

Subacute Thyroiditis is Associated with HLA-B*18:01, -DRB1*01 and -C*04:01—The Significance of the New Molecular Background

“…The new data regarding the influence of SAT-risk HLA alleles on the clinical course of the disease may facilitate diagnosis and treatment. In some patients, the SAT US image may be challenging to evaluate, as-for example-the typical US pattern and vascularization in SAT is sometimes similar to that of the early phase of chronic autoimmune thyroiditis [29]. In HLA-B*18:01 carriers, the SAT US pattern may be highly misleading, largely resembling a large thyroid tumor [27].…”

The Clinical Value and Variation of Antithyroid Antibodies during Pregnancy

“…After the application of antithyroid drugs (ATDs), the abnormal elevation of TRAbs can be used to predict GD recurrence risk [ 43 ]. TRAbs correlates positively also with thyroid vascularization at color-flow doppler and the odds of hyperthyroidism recurrence [ 44 ]. It has been reported that in GD patients developing hypothyroidism, TSAbs increase significantly 6 months after radioiodine treatment.…”

Eosinophil/Monocyte Ratio Combined With Serum Thyroid Hormone for Distinguishing Graves' Disease and Subacute Thyroiditis

“…Differentiation of destruction-induced thyrotoxicosis (painless or subacute thyroiditis) from GD is important for the selection of the correct therapy. GD but not SAT can be triggered by stressful events (8,9) and albeit hypoechogenicity can be present in both, even though in GD the thyroid is diffusely hypoechoic, hypervascularization is generally not present in patients with SAT (10,11). It is, however, often difficult to make this distinction without measurement of RAIU.…”