Expression of antithyroid antibodies in a large family with high prevalence of thyroid autommune disease and follow-up of patients with Grave's disease

ABSTRACT

This study included 40 families [179 persons] with familial goiter [more than one member in the family had goiter]. Fifteen families had Grave's disease, 85 had Hashimoto's thyroiditis, 6 in remission [defined as clinical and biochemical euthyroidism for at least one year after withdrawal treatment] and 73 relatives [parents and sibs]. Seventy-two age and sex matched healthy subjects were included as a normal control group. Thyroid function was evaluated at diagnosis by measuring free triiodothyronine [FT3], thyroxine [FT4] and thyroid stimulating hormone [TSH]. Antithyroglobulin [ATG] and antithyroid peroxidase [TPO] antibodies were also measured. At the follow up of patients with Grave's disease, 30 patients with Grave's disease were examined clinically and thyroid profile [FT3, FT4 and TSH] were performed after 4-8 weeks of starting antithyroid drugs [ATDs], then every 2-3 m, thereafter. Thyroid antibodies [ATPO and ATG] were done before the start of treatment and follow up antithyroid antibodies were measured after six months and one year. Thyroid imaging using Tc99m thyroid scan and thyroid ultrasound [US] were performed at diagnosis for all patients. It was concluded that anti TPO and anti TG represent an additional parameter with potential interest in the clinical diagnosis and Hashimoto's thyroiditis. ATDs are safe and remain the treatment of choice of Graves' disease in children and adolescents. However, a long-term follow up is required for these patients as a high relapse rate is observed