Relationship between thyroid volume and autoantibodies in patients with autoimmune thyroid disease / 中华地方病学杂志

Objective:To study the relationship between thyroid volume (TV) and thyroid autoantibodies in patients with autoimmune thyroid disease (AITD), and to explore the factors affecting goiter in patients with AITD.Methods:The newly diagnosed AITD adult patients in the Affiliated Hospital of Shanxi Institute for Endemic Disease Prevention and Control from November 2019 to October 2020 were selected for questionnaire survey, physical examination, thyroid function and thyroid autoantibody test, determination of serum iodine content and thyroid ultrasound, and the correlation between thyroid volume and thyroid autoantibody was analyzed.Results:A total of 147 newly diagnosed adult AITD patients were included, including 63 cases of Graves' disease (GD, 30 males and 33 females) and 84 cases of chronic lymphocytic thyroiditis (HT, 29 males and 55 females). The TV of male and female patients with GD was positively correlated with the levels of thyrotropin receptor antibody (TRAb) ( rmen = 0.515, rwomen = 0.412, P < 0.05). The TV of male and female patients with HT was not correlated with the levels of thyroid peroxidase antibody (TPOAb) and thyroglobulin antibody (TGAb, rmen = - 0.137, 0.168, rwomen = 0.184, - 0.088, P > 0.05). There were no correlation between TPOAb levels and TGAb levels in male and female HT patients ( rmen = 0.153, rwomen = 0.102, P > 0.05). The TV of male and female patients with GD or HT was not correlated with the serum levels of iodine ( rmen = 0.230, 0.013, rwomen = 0.096, 0.069, P > 0.05). Conclusion:TRAb level is positively correlated with the TV in GD patients.

Effect of thyroxine level on gestational diabetes mellitus and pregnancy outcome / 解放军医学杂志

Objective: To investigate the effect of thyroxine level on the onset of gestational diabetes mellitus (GDM), pregnancy outcome and the basic conditions of neonates. Methods: The related information of 1903 cases of pregnant women were prospectively collected from the Department of Obstetrics, Shanghai Changhai Hospital. Selecting group A (gravida with low thyroxinemia, n=36), group B (gravida with pure thyroid peroxidase antibody (TPOAb) positive, n=113) and group C (gravida with normal thyroid function, n=1539) according to the results of thyroid function test in newly constructed card. The incidence of GDM and the related index of thyroid function and glucose metabolism during the second trimester of pregnancy were compared among the three groups. Gravida with GDM in the three groups were group D (9 cases), group E (32 cases) and group F (367 cases), respectively. The differences of pregnancy outcome and the basic conditions of neonates among them were compared. Results: No significant differences existed (P>0.05) in the incidence of GDM during different pregnant period in groups A, B and C (First trimester: 50.00% vs. 25.00% vs. 34.69%; Second trimester: 21.88% vs. 28.71% vs. 22.70%). In the second trimester, the level of glycosylated hemoglobin (HbA1c) was significantly higher in group A than in group C [4.80%(4.60%, 5.00%) vs. 4.70%(4.40%, 4.90%)], w hi le the fasting glucose level was significantly higher in group B than those in group C [(4.69±0.59) mmol/L vs. (4.58±0.43) mmol/L, P0.05). Conclusions: Different levels of thyroxine have no significant effect on the incidence of GDM, but throw some effects on the glucose metabolism in the second trimester. In addition, positive TPOAb may increase the incidence of premature delivery and fetal distress in pregnant women with GDM, and affect fetal growth and development to some extent. Thyroid function status should be evaluated in the early stages of pregnancy, and regular follow-up should be conducted for patients with TPOAb positivity and timely intervention if necessary.

Study on the correlation between smoking and hypothyroidism in iodine-suitable areas / 中华内分泌代谢杂志

Objective To explore the relationship between different smoking status and hypothyroidism in six iodine-suitable areas of China. Methods A total of 8187 residents were investigated by cluster sampling in six cities, and 7448 residents were included in the survey. The height, weight, waist circumference, and blood pressure were measured by filling out epidemiological questionnaire. Blood samples were collected to detect thyroid stimulating hormone ( TSH) , thyroid peroxidase antibody ( TPOAb) , and thyroglobulin antibody ( TgAb) . Results The mean TSH, TPOAb, and TgAb positive rates in passive smoking and active smoking groups were all lower than those in non-smoking group ( all P<0.01) . In the active smoking group, the TSH value decreased by 0.023 units for every unit increase in smoking index. The positive rates of TgAb and TPOAb in both passive smoking and active smoking groups were lower than those in non-smoking group (all P<0.01). Active and passive smoking reduced the prevalence of hypothyroidism (both P<0.01). Among women, the risks of clinical hypothyroidism and subclinical hypothyroidism were reduced in both active and passive smoking groups. Besides, the risk of subclinical hypothyroidism decreased significantly when the smoking index was more than 70. In male population, the risk of subclinical hypothyroidism in active and passive smoking group decreased. Besides, the risk of clinical hypothyroidism and subclinical hypothyroidism decreased significantly when the smoking index was more than 70. Conclusion Smoking in iodine-suitable areas may reduce TSH level and the positive rates of TPOAb and TgAb.

Prevalence of autoimmune thyroiditis in patients with type 1 diabetes: a long-term follow-up study

PURPOSE: Type 1 diabetes mellitus (DM) is associated with autoimmune diseases such as thyroiditis. Therefore, we aimed to investigate the prevalence of autoimmune thyroiditis in patients with type 1 DM. METHODS: A total of 102 patients who were diagnosed and followed up (mean age, 8.1±4.0 years) in Ajou University Hospital were enrolled in this study. All the patients were evaluated for beta cell autoimmunity, including insulin autoantibody, glutamic acid decarboxylase antibodies (GADA), and islet cell antibody. Moreover, autoantibodies to thyroid peroxidase and thyroglobulin were assessed at initial diagnosis and annually thereafter. RESULTS: The mean patient age (49 men and 53 women) was 19.2±4.8 years. The prevalence of at least one thyroid antibody was 30.4%. Patients with thyroid anti­bodies had a significantly higher frequency of GADA at the time of the diagnosis. Autoimmune thyroiditis was more prevalent in the older age group. GADA was a significant risk factor for development of thyroid autoantibodies after diagnosis of type 1 DM (odds ratio, 4.45; 95% confidence interval, 1.399–14.153). CONCLUSIONS: In patients with type 1 DM, the prevalence of autoimmune thyroiditis was higher than in the general population. Moreover, GADA positivity at diagnosis was associated with thyroid autoimmunity.

Retrospective analysis of the effect of gestational hypothyroxinemia on pregnancy outcomes / 解放军医学杂志

Objective To discuss the influence of gestational hypothyroxinemia to the pregnancy outcomes and fetus development,and find the evidence of hormone replacement therapy.Methods The clinical data of 1141 gravida admitted from Nov.2014 to Oct.2015 were retrospectively analyzed,including the data of systematic antenatal examination,all the data of pregnancy,the materials of delivery,the last ultrasound examination,production status and the thyroid stimulating hormone (TSH) of the newborn etc.,to find the difference of related index.Results Of the 1141 gravida with integral data,200 had past history of thyroid disease,189 showed below normal of free thyroxine (FT4) and 752 were normal ones.The 189 gravida with normal TSH but lower FT4 were divided into group A (0-5％ lower than the normal FT4 value,n=60),group B (5％-10％ lower than the normal FT4 value,n=40) and group C (10％ and above lower than the normal FT4 value,n=89).The ones with both normal TSH and FT4 value served as control group.Compared to the control group,the higher premature delivery rate,incidence of gestational diabetes mellitus and cesarean delivery rate (P＜0.05) were found in group C,and more gravida in group B had a history of hypertension and dyslipidemia during pregnancy (P＜0.05).The cesarean delivery rate of group B and C were higher than group A.Meanwhile,the rate of group B was higher than control group (P＞0.05).At delivery,the maternal weight,BMI,diastolic pressure,and head circumference of fetus in the last ultrasound examination were higher in group C than in control group (P＜0.01),but the gestational weeks of the newborn were shorter in group C (38.55 ± 1.86 weeks) than in control group (39.14 ± 1.57 weeks,P＜0.01).The 189 gravida with lower FT4 were divided into two groups according to the thyroid peroxidase antibody (TPOAb) level.The head circumference of fetus in the last ultrasound examination was higher in TPOAb(+) group than in TPOAb(-) group (45.99 ± 62.36cm vs.33.23 ± 2.08cm,P＜0.01).Conclusions The influence of gestational hypothyroxinemia to pregnancy outcomes and fetus development cannot be ignored,especially for the pregnant women with lower FT4 value (10％ and above lower than the normal) or with positive TPOAb.It is suggested to take the thyroid function test in the early stage of pregnancy for those pregnant women mentioned above.

Changes of thyroid autoantibodies and its relationship with dyslipidaemia in children with Turner syndrome / 中华实用儿科临床杂志

Objective To investigate the changes of thyroid autoantibody(TAA)in children with Turner syndrome(TS),and its association between TAA and thyroid dysfunction,age,karyotype and dyslipidaemia.Methods Thirty-two patients with TS diagnosed by chromosome analysis hospitalized at Sun Yat-Sen Memorial Hospital,Sun Yat-Sen University from July 2007 to July 2015 were divided into 2 groups based on TAA-positive or TAA-negative,then the thyroid dysfunction,the age,the karyotype and the lipid metabolism were compared between 2 groups.Results Of the 23 cases of TAA-positive girls(23/32 cases,71.88％),9 girls(39.13％)suffered from thyroid dysfunction;of the 9 cases of TAA-negative girls(9/32 cases,28.12％),3 girls(33.33％)had thyroid dysfunction.As compared with the girls in TAA-negative group,the age in TAA-positive group was significantly higher[(12.08±2.90)years old vs.(8.89±4.17)years old],and the difference was significant(t=101.500,P=0.047).The patients were divided into 4 age groups:0-5 years old,>5-10 years old,>10-15 years old and >15 years old;the rates with TAA-positive were 25.00％(1/4 cases),75.00％(6/8 cases),82.35％(14/17 cases)and 66.67％(2/3 cases)respectively.Twenty patients received the lipid metabolism test,and 11 cases(11/20 cases,55.00％)of them suffered from dyslipidaemia,9 cases of them were TAA-positive(9/11 cases,81.82％),and 2 cases were TAA-negative(2/11 cases,18.18％).The differences in the prevalence of dyslipidaemia between the 2 groups were significant(x2=4.848,P=0.028).There was no significant difference in the numbers of TAA-positive cases among different karyotypes(x2 =4.246,P=0.120).Conclusions Patients with TS are prone to suffer from thyroid dysfunction and dyslipidaemia.Timely detection of TAA and thyroid function is recommended,as well as the lipid metabolism if necessary.

Thyroid Autoantibody Positive Anti-N-Methyl-D-Aspartate Receptor Encephalitis

BACKGROUND: Hashimoto's encephalopathy (HE) and anti N-methyl-D-aspartate receptor (NMDAR) encephalitis have clinical overlaps. CASE REPORT: A 70-year-old woman presented with acutely developed confusion, disorientations and psychosis. HE was suspected based on goiter, markedly elevated anti-thyroglobulin and anti-thyroid peroxidase antibody. She was placed on high dose steroid and intravenous immunoglobulins administration, which did not ameliorate her symptoms. After the antibodies to the NMDAR were identified, weekly 500 mg of rituximab with 4 cycles were started. The current followed up indicated a complete recovery. CONCLUSIONS: The possible associations between NMDAR antibody and autoimmune thyroid antibodies in anti-NMDAR encephalitis with positive thyroid autoantibodies remain unclear. However, a trend toward a higher incidence of NMDAR antibody in patients with autoimmune thyroid antibodies than without has been observed. Cases of encephalitis with only NMDAR antibody (pure anti-NMDAR encephalitis) also occur. Therefore, it is important for clinicians to know the clinical and pathogenic differences between anti-NMDAR encephalitis with positive thyroid autoantibody and pure anti-NMDAR encephalitis for relevant treatment, predicting prognosis, and future follow-up.

Association of Cognitive Dysfunction with Thyroid Autoantibody / 정신신체의학

OBJECTIVES: The aims of this study were to know the frequency of cognitive dysfunction among patients with autoimmune thyroid disorders, and to reveal influencing factors on it, especially to clarify association with autoimmune thyroid antibodies. METHODS: From sixty-five female patients with autoimmune thyroid disorders, demographic data were obtained by structured interview. Their cognitive funtions were measured using the MMSE-K and the MoCA-K tests. Depression was evaluated by the K-HDRS. RESULTS: 1) Among patients with autoimmune thyroid disorders, 7.69% of them were below 24 on the MMSE-K, while 10.77% were below 22 on the MoCA-K. The frequency of cognitive deficit was not significantly different according to having positivity to antimicrosomal antibodies or not. 2) The antimicrosomal antibody-positive patients had significantly higher antithyroglobulin antibody titers, antimicrosomal antibody titers, and TSH concentration, while had significantly lower free T4 levels(p<0.05, respectively). 3) The total scores of the MMSE-K and the MoCA-K had significant correlation with age, marital status, antithyroglobulin antibody titers and K-HDRS(p<0.05, respectively). 4) The regression analysis revealed that variables such as age, education, autoimmune thyroid antibodies, thyroid function and depression did not influence on cognitive function of patients with autoimmune thyroid disorders. CONCLUSIONS: Our results could not support that cognitive function of patients with autoimmune thyroid disorders had correlation with autoimmune thyroid antibodies.

Analysis of the clinical data of 2843 patients with thyroid nodules / 中华内分泌代谢杂志

Objective To analyze the clinical and pathological characteristics of thyroid nodules.Methods A retrospective analysis of the clinical data of 2843 Han patients with thyroid nodules from January 2009 to June 2011 in Henan province was performed.Results The most high-risk of thyroid nodule resided in the group aged 45-54.The main pathological manifestation was simple nodular goiter.The rate of preoperative misdiagnosis was 2.4％.22.1％ of the patients with thyroid nodules showed abnormal thyroid function,which was mainly as subclinical thyroid dysfunction.The positive rate of thyroid peroxidase antibody (TPOAb) in patients with thyroid nodule was 19.8％ while that of thyroid globulin antibody (TgAb) was 20.0％.Among all 2843 subjects,the prevalence of differentiated thyroid carcinoma (DTC) was 28.8％,and the incidence of DTC was accompanied by raised TSH levels.The prevalence of DTC exceeded 40％ in patients aged between 25 to 34 as well as more than 74 years old.The prevalence of DTC was up to 33.8％ in TgAb positive patients.There was no difference in TPOAb levels between DTC patients and non DTC patients (P =0.406),but the TgAb level in patients with DTC was significantly higher than that of non DTC patients (P =0.033).Conclusion Thyroid nodule patients aged 25-34 or older than 74 formed high-risk groups of DTC.The serum TSH level and TgAb level were positively correlated with the risk of DTC.

Thyroid Dysfunction of North Korean Women Living in South Korea, Focusing on Subclinical Hypothyroidism

BACKGROUND: Thyroid function depends on ethnic and environmental factors. North Korean refugees have the same genetic background as South Koreans, but they have been exposed to different environments. This study examines the prevalence and pattern of thyroid disorders in North Korean women living in South Korea, focusing on subclinical hypothyroidism (SCH). METHODS: The intended sample was a total of 327 North Korean women residing in Seoul. Health questionnaires and medical examinations, including serum thyrotropin (thyroid stimulating hormone, TSH), free thyroxine, and thyroid autoantibodies, were conducted. RESULTS: The prevalence of SCH was 9.4%. In logistic regression analysis, smoking, menopause, length of stay in South Korea, body mass index, history of thyroid disease, and metabolic syndrome were not associated with the risk of SCH. Whereas, the positivity of autoantibodies were associated with a high risk for SCH (odds ratio [OR], 4.840; 95% confidence interval [CI], 1.80-13.017; P = 0.002), and age was associated with a low risk for SCH (OR, 0.94; 95% CI, 0.888-0.994; P = 0.031). The serum TSH levels also decreased with increasing age, and in particular, there was significant difference between 30-39 years, and over 60 years (2.33 +/- 1.51 microIU/mL vs. 1.54 +/- 0.73 microIU/mL, P = 0.028). CONCLUSION: In North Korean women, the positivity of autoantibodies was associated with a high risk for SCH. But interestingly, a younger age was associated with a high risk for SCH. Considering that they suffered from severe famine at the period of growth, and this led to malnutrition, their thyroid dysfunction might be associated with the peculiar environment that they experienced.

The impact of maternal thyroid diseases on the pregnant outcome in the first trimester of pregnancy / 中华内分泌代谢杂志

Objective To evaluate the association between maternal thyroid diseases in the first trimester of pregnancy and obstetric complications.Methods A total of 2 517 pregnant women from 10 hospitals in Shenyang during the first 12 weeks of gestation were enrolled in this study.All sera obtained from pregnant women were measured for thyroid-stimulating hormone (TSH),free thyroxine ( FT4 ),and thyroid peroxidase antibody (TPOAb).Collected items include obstetric outcomes and complications.Results Serum TSH above 2.5 mlU/L during the first trimester of pregnancy increased the rate of spontaneous abortion ( 8.69％ vs 6.38％,P =0.048 ),even if subclinical hypothyroidism (9.50％ vs 6.38％,P =0.009).TSH above the gestational special reference range,passive smoking,and over 30 years were independent factors for increasing the rate of spontaneous abortion.Hyperthyroidism and hypothyroidism with drug treatment to maintain normal thyroid function during pregnancy reduced the incidence of spontaneous abortion.Increased or decreased levels of serum TSH and TPOAb(+) were not related with other obstetric complications.Conclusion Serum TSH above the gestational special reference range during the first trimester of pregnancy is a risk factor of spontaneous abortion; maintaining TSH within the normal range by treating hyperthyroidism or hypothyroidism may reduce spontaneous abortion rate.

Prognostic Significance of Thyroid Autoantibodies in Urticaria / 대한피부과학회지

BACKGROUND: The association between chronic urticaria and thyroid autoantibodies is now generally accepted, and some authors recommend screening for thyroid autoimmunity and function in all patients with chronic urticaria for early identification of patients who might require treatment of underlying thyroid dysfunction or follow-up. However, the prognostic significance of thyroid autoantibodies in urticaria patients is still unclear. OBJECTIVE: To evaluate antibody reactivity as a prognostic factor, the association between antibody positivity and disease duration were analyzed. METHODS: Medical records from March 2002 to October 2010 of urticaria patients (M: 41, F: 125), who were tested for thyroid auto-antibodies at their first visit, were collected and reviewed for the duration of urticaria. Patients with a 6-week or longer history of urticaria were categorized into the chronic urticaria group; patients whose urticaria resolved within 6 weeks were categorized into the acute urticaria group. RESULTS: A positive result to the thyroid autoantibody was shown by 28.9% of chronic urticaria patients and 10.7% of acute urticaria patients. Average duration of urticaria in patients who were thyroid autoantibody positive was 33.9 weeks, while patients with thyroid autoantibody negative tests had urticaria for 6.9 weeks on average. The frequency of a positive result to only the thyroid peroxidase antibody was different between the chronic urticaria group (15.6%) and the acute urticaria group (2.5%). CONCLUSION: According to our results, the average duration of urticaria in patients with thyroid autoantibodies was significantly longer than in urticaria patients without thyroid autoantibodies. Thyroid autoantibodies were statistically meaningful prognostic factors predicting the duration of urticaria.

Long-term Follow-up Outcome in Children and Adolescents with Hashimoto's Thyroiditis / 대한소아내분비학회지

PURPOSE: Hashimoto's thyroiditis is the most common cause of thyroid disease in children and adolescents. It shows a wide spectrum of thyroid functions, ranging from hypothyroidism to hyperthyroidism, with variable clinical course. This study was undertaken to investigate the clinical course and outcome of Hashimoto's thyroiditis with long-term follow-up in children and adolescents. METHODS: We analyzed retrospectively clinical data in 85 girls diagnosed as Hashimoto's thyroiditis in the pediatric endocrinology clinic at Asan Medical Center from January 1996 to June 2006. Of 24 patients, who had been followed up for more than five years, we investigated age at diagnosis, family history, initial thyroid function, initial thyroid autoantibody titers, changes of thyroid function, and changes of positivity rate of thyroid autoantibody. RESULTS: The mean age at diagnosis was 10.9+/-2.6 years. Goiter was found in about 95% of patients, whereas 5 patients presented with short stature. Positive family history of autoimmune thyroid disease was documented in 27 out of 85 patients (31.8%). At diagnosis, 34 of 85 patients (40.0%) were in euthyroidal status, 43 (50.7%) in overt or compensated hypothyroidism, and 8 (9.4%) in hyperthyroidism. Among the 24 patients followed up for more than five years, 7 patients were in euthyroidal status, 16 in overt or compensated hypothyroidism, and 1 in hyperthyroidism at initial presentation. Four patients initially diagnosed with euthyroidism remained in euthyroidal status, while 7 patients with hypothyroidism were shifted to euthyroidism. Overall, 15 out of 24 patients were in remission status at the last follow-up. Initial TSH level was significantly higher in non-remission group (P=0.016). Initial thyroid autoantibody titers were not correlated with remission rate. CONCLUSION: The clinical course of children and adolescents with Hashimoto's thyroiditis varied widely. After more than five years follow-up, 62.5% of patients remained or became euthyroid. Initial TSH level can be a prognostic factor of Hashimoto's thyroiditis.

Three Cases of Autoimmune Thyroid Disease in a Family through Three Generation / 대한내분비학회지

According to recent studies, the immunogenetic factors are thought to be account for a part of the etiopathogenesis of autoimmune thyroid disease. In Korea, there was one report on the relationship between HLA DR5, DR8, B13 and autoimmune thyroid disease. There were also several reports on a familial hereditary transmission of autoimmune thyroid disease in other countries but not in Korea. We describe the occurrence of autoimmune thyroid disease that affected three members of a family through three generations. This is the first report on familial hereditary transmission of autoimmune thyroid disease in Korea. We report on an 80-year-old woman who presented with Hashimoto's thyroiditis, her 53-year-old daughter who had Graves' disease, and her 29-year-old grand-daughter who had Graves' disease. In order to identify the immunogenetic influence in these cases, HLA haplotypes & thyroid autoantibody were studied. HLA DRB3*02 was obseved in each of the patents. HLA DQB1*0301, DR11, DQB1*05031 and DR14 were observed in the two cases. However, HLA B13, DR5 and DR8 were not observed. The patients are currently undergoing follow-up using PTU, methimazole and synthyroid medication.

The clinical significance of thyroid auto-antibodies in patients with chronic idiopathic urticaria / 천식및알레르기

BACKGROUND AND OBJECTIVES: Chronic idiopathic urticaria refers to recurrent hives of more than six weeks duration and in approximately 80% of cases, the etiology is unknown. Recently, involvement of an autoimmune mechanism in the pathogenesis of chronic idiopathic urticaria has been suggested. Thyroid autoimmunity has been reported in patients with chronic idiopathic urticaria and treatment with thyroxine in selected cases induced clinical remission. MATERIALS AND METHODS: We studied 99 patients with chronic idiopathic urticaria to evaluate the clinical significance of anti-thyroid auto-antibodies including anti-thyroglobulin and antimicrosomal antibodies. Thirty-four normal volunteers were selected as controls. The prevalence of these two auto-antibodies as well as laboratory findings and clinical features between these two groups were compared. RESULTS: Thyroid auto-antibodies were positive in 24% of patients compared to 8.7% of control patients and the duration of the disease was significantly longer in the patients with thyroid auto-antibodies than in those without thyroid auto-antibodies, respectively (p<0.05). There was no significant difference in age, positive rate of ANA and total eosinophil count. Administration of thyroxine to five patients with refractory urticaria resulted in improvement in three patients. CONCLUSION: Thyroid autoimmunity is associated with chronic idiopathic urticaria in some patients. Administration of thyroxine resulted in improvement of symptoms in some of these patients. Therefore, we recommend routine testing of thyroid auto-antibodies in patients with retractable chronic idiopathic urticaria.

The Incidence of Thyroid Autoantibody in Subacute Thyroiditis and the Clinical Characteristics of Greeping Thyroiditis / 대한내분비학회지

Background: Subacute thyroiditis is a spontaneously resolving inflammatory disorder of thyroid gland, usually associated with painful goiter and short-lived thyrotoxicosis. Although its etiology is yet to be established, much evidence suggests viral infections and genetic factors play important roles. Usually, both lobes of thyroid gland are involved simultaneously, but in some patients one lobe is involved first and the other later(creeping thyroiditis), Thyroid autoantibodies which might appear probably due to inflammatory release of thyroid antigens, are found in a variable number of patients with subacute thyroiditis. However there have been few detailed reports on their incidence in Korean patients with subacute thyroiditis. So, we were to see the elinical characteristics of patients with subacute thyroiditis with special regards to the incidence of thyroid autoantibodies and to the incidence and characteristics of creeping thyroiditis, Methods: We reviewed the clinical records of 85 patients with subacute thyroiditis(7 men and 78 wornen, meam age of 43+9 years) who had visited the thyroid clinic in Seoul National University Hospital between 1986 and 1994. Results: At initial visit, the incidenees of thyroid autoantibodies were as follows: anti- microsomal antibody 7.8%, anti-thyroglobulin antibody 22.1%, and thyratropin binding inhibitor inununglobulin 6.3%. During the follow-up period, thyroid autoantibodies appeared most frequently between the first and the second month after initial visit. Compared to those with non-creeping thyroiditis, the patients with creeping thyroiditis(21.4%) had nonspecific systemic sy~rnptoms more frequently(89% vs. 42%, p<0.05). They required steroid therapy more ftequently(89% vs. 52%, p <0.05), and needed longer duration of treatment(9.3+6.2weeks vs, 4.7+3.7weeks, p<0.05). The incidence of abnormalities in liver function and the incidence of thyroid autoantibodies were higher in non-creeping thyroiditis group. Conclusion: In accordance with previous reports, thyroid autoantibodies were detected in only a small portion of Korean patients with subacute thyroiditis. Rather different clinical manifestations and different incidences of thyroid autoantibodies between ereeping group and non-creeping group suggest differences in the pathogenetic mechanisms between those two groups. However, there is need for further study to validate such observation and to elucidate the mechanisms.

Correlation of serum TSH and thyroid autoantibodies with cytopathologic changes of thyroid in autoimmune thyroiditis / 西安交通大学学报(医学版)

Objective To analyze the relationship of serum levels of TSH,thyroid peroxidase antibody(TPOAb) and thyroglobulin antibody(TGAb) with cytopathologic changes of thyroid fine needle aspiration(FNAB) in autoimmune thyroiditis(AIT).Methods Totally 82 cases of cytologically confirmed AIT including 75 females and 7 males were collected.Levels of TSH,TPOAb and TGAb were tested.After execution of FNAB,features of the cytopathology were observed.Results ① The percentage of positive TPOAb and TGAb were 91.4% and 74.4%,respectively in all the AIT patients.47.6% of the patients had TSH levels within normal range(0.3～5 mu/L).② All of the slides had different grades of lymphocytic infiltration.49.3% had germinal center,32.8% had Askanazy cells,26.9% had plasma cells,22.4% had colloid,and 9% had multinuclear giant cells.③ Lymphocytic infiltration was divided into four degrees.The levels of TSH and TPOAb increased significantly in the extremely heavy lymphocytic infiltration grade than in the others(P