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Development of spontaneous hypothyroidism in patients with Graves' disease treated with antithyroidal drugs: clinical, immunological, and histological findings in 26 patients.
- Source :
-
The Journal of clinical endocrinology and metabolism [J Clin Endocrinol Metab] 1989 Jul; Vol. 69 (1), pp. 49-53. - Publication Year :
- 1989
-
Abstract
- Graves' disease may result eventually in hypothyroidism in approximately 5-20% of patients. In a few such patients hypothyroidism was associated with TSH-blocking antibodies, but whether the frequency of TSH-blocking antibodies in such patients is as high as it is (21%) in patients with primary myxedema is not known. This study was undertaken to determine the presence of various immunoglobulins [TSH binding inhibitor immunoglobulins, thyroid-stimulating antibodies (TSAb), and TSH-blocking antibodies] in 26 patients with Graves' disease who developed hypothyroidism from 0.5-10 yr or more after discontinuation of antithyroid drug therapy. Eight of the 26 patients (31%) had TSH-blocking antibodies, 16 (61%) had TSAb, and 14 (54%) had thyroid hormone binding inhibitor immunoglobulins. Thyroid needle biopsies were performed in 9 patients. Three of 5 patients who had subclinical hypothyroidism had chronic lymphocytic thyroiditis, and all had positive TSAb titers. Three patients had the fibrous variant of chronic lymphocytic thyroiditis; their TSAb values were 902%, 431%, and 1290%. One patient had follicular hyperplasia. We conclude that TSH-blocking antibodies may account for hypothyroidism in approximately one third of patients with Graves' disease who were previously treated with antithyroid drugs, and that autoimmune thyroiditis is comparable for the hypothyroidism in the remaining two thirds of Graves' disease patients.
- Subjects :
- Adolescent
Adult
Female
Follow-Up Studies
Graves Disease immunology
Humans
Hypothyroidism immunology
Hypothyroidism pathology
Immunoglobulins, Thyroid-Stimulating
Male
Middle Aged
Thyroid Function Tests
Thyroid Gland immunology
Thyroid Gland pathology
Thyroiditis, Autoimmune immunology
Antibodies analysis
Antithyroid Agents adverse effects
Graves Disease drug therapy
Hypothyroidism chemically induced
Immunoglobulin G analysis
Subjects
Details
- Language :
- English
- ISSN :
- 0021-972X
- Volume :
- 69
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- The Journal of clinical endocrinology and metabolism
- Publication Type :
- Academic Journal
- Accession number :
- 2471711
- Full Text :
- https://doi.org/10.1210/jcem-69-1-49