Thyroid disease epidemiology has changed recently. This change may be related to changes in the iodine status of the environment. Iodine deficiency was observed in earlier years in Greece. The progression of multinodular goiter to hyperthyroidism was frequently observed. Nowadays, the development of autoimmune thyroiditis is frequently observed in patients with simple or nodular goiter. This development may be related to the proinflammatory action of iodine, iodine being nowadays adequate in the environment.
The aim was the long term follow up of patients with simple or micronodular goiter in the area of Athens.
We studied 87 patients, 80 female and 7 male, aged 4070 years, with simple goiter, micronodular goiter or nodular goiter. All of them had undetectable antithyroid antibodies at presentation. We followed up these patients for 58 years. During follow up 24 patients developed detectable antithyroid antibodies, in 2 of them only antithyroglobulin antibodies being detected. In 18 of them a progressive increase of the antibodies was observed, 1 patient female developing hypothyroidism due to autoimmune thyroiditis. Within the group of the patients with detectable antithyroid antibodies 5 had a positive family history for autoimmune thyroid disease.
During long term follow up patients with goiter appear to develop antithyroid antibodies, progression to autoimmune hypothyroidism being however infrequent. This development may be related to the iodine sufficiency currently observed in modern Greece, particularly in the area of Athens.