Aim: Analyzing the evolution of thyroid function in thyroiditis and related disease during 117 years.
Materials and methods: i) Diagnostic: Hashimotos thyroiditis (HT): a) antithyroperoxydase antibodies (ATPO) cut-off 34 IU/ml. b) If ATPO=normal, thyroiditis was considered if high antithyroglobuline antibodies (T-ATG). c) Idiopathic mixedema (IM): hypothyroidism, no ATPO, no ATG, and no TRAB. ii) Patients: HT: 1196; T-ATG: 73; IM: 69. Women/men: HT: 1136/60; T-ATG: 69/4; IM: 60/9 (more men: P=0.009). iii) Statistical analysis: χ2 test.
Results: i) At the diagnostic moment. a) HT: euthyroid (EUT): 534 (44.5%), hypothyroid (HOT): 498 (~41.5%), hyperthyroid (HIT): 168 (14%) from these: 155 (~87%) associated with GravesBasedow disease (GBD)(TRAB+; more than in T-ATG). b) T-ATG: EUT: 43 (59%, more than in HT), HOT: 21 (~29%), HIT: 9 (12,33%) from these: 5 (~55%) associated with GBD(TRAB+). c) IM (by definition): HOT: 69 (100%). d) Significant difference between HT vs T-ATG: P=0.049.
ii) Follow-up. a) HT: 28 (5.24%) with EUT became HOT after 0.2 (!)8 years (av=2.76, S.D.=2.25). 3 (0.56%) with EUT become HIT (all GBD). 100% HOT remained HOT. 16 (9.52) with HIT become EUT after 1.52 years and maintain at least 5 years. 4 (2.38%) with HIT become spontaneously HOT (two with GBD). b) T-ATG: only two HIT become EUT (22%). EUT&HOT remain the same. c) IM: all remained HOT, with 1 exception (man under amiodarone who return spontaneously to EUT after withdrawal amiodarone).
Conclusions: i) Thyroiditis with only hyper-ATG could be considered different from HT. ii) HT, T-ATG, and IM presented differently as hormonal function. iii) T-TAG more than HT (but both) presented more as EUT than HOT. iv) Only 5% EUT-HT become HOT, during first 8 years. v) No EUT-HT after 8 years modified function. vi) Patients with HOT at diagnostic time, either HT, T-ATG or IM, remain HOT.
27 Apr - 01 May 2013
European Society of Endocrinology