Conversion to Graves disease from Hashimoto thyroiditis: a study of 24 patients
Arch. endocrinol. metab. (Online)
;
62(6): 609-614, Dec. 2018. tab, graf
Article
Dans Anglais
| LILACS
| ID: biblio-983815
ABSTRACT
ABSTRACT Objective:
The conversion of Hashimoto's thyroiditis (HT) to hyperthyroidism due to thyrotropin receptor antibodies is intriguing and considered rare. The contribution of TSH receptor blocking antibodies (TRAb), which may be stimulators (TSAb) or blockers (TBAb), is suspected. We describe clinical and biological variables in a series of patients switching from Hashimoto's thyroiditis to Grave's disease. Subjects andmethods:
Retrospective case study of 24 patients with Hashimoto's thyroiditis followed during 48 ± 36 months that developed later Graves' disease (GD). These variables were analysed in the hypo and hyperthyroid phase age, sex, initial TSH, free triiodothyronine (fT3), free thyroxine (fT4), anti-TPO, TBII antibodies, parietal cell autoantibodies, time between hypo and hyperthyroidism, thyroid volume and levothyroxine doses (LT).Results:
In HT, mean TSH was 9.4 ± 26.1 UI/L and levothyroxine treatment was 66.2 ± 30.8 µg/day. The switch to GD was observed 38 ± 45 months after HT diagnosis. As expected, we found significant differences on TSH, FT3, FT4 and TBAb levels. Three out of 14 patients had parietal cell autoantibodies. In two of these three cases there was an Helicobacter pylori infection. There were no significant differences between HT and GD groups with respect to thyroid volume.Conclusions:
To our knowledge, large series documenting the conversion of HT to GD are scarce. Although rare, this phenomenon should not be misdiagnosed. Suspicion should be raised whenever thyroxine posology must be tapered down during the follow-up of HT patients. Further immunological and genetic studies are needed to explain this unusual autoimmune change.
Texte intégral:
Disponible
Indice:
LILAS (Amériques)
Sujet Principal:
Récepteur TSH
/
Maladie de Basedow
/
Maladie de Hashimoto
Type d'étude:
Étude observationnelle
Limites du sujet:
Adulte
/
Femelle
/
Humains
/
Mâle
langue:
Anglais
Texte intégral:
Arch. endocrinol. metab. (Online)
Thème du journal:
Endocrinologie
/
Métabolisme
Année:
2018
Type:
Article
Pays d'affiliation:
Belgique
/
Inde
/
Espagne
Institution/Pays d'affiliation:
CHU/BE
/
University Hospital Juan Ramón Jiménez/ES
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