Effect of post-operative thyroid hormone therapy on the recurrence of benign thyroid nodules. A study in Thai patients.

The efficacy of postoperative thyroid hormone treatment in prevention of recurrent thyroid nodule is still controversial. In order to investigate this effect in Thai patients, a retrospective study was performed on files of 321 post-operative patients with benign thyroid nodules, who were either on thyroid hormone treatment or not after surgery, and were followed-up for at least 1 year. The longest follow-up period was 15 years after surgery. The recurrence of nodules was determined by palpation. It was found that the recurrent rate in patients with adenoma who did not receive post-operative thyroid hormone treatment was 20 per cent (16/82 cases) while there was no recurrence at all (0/25 cases) in the treatment group (p < 0.05). The recurrent rate was 22 per cent (31/141 cases) in patients with nodular goitre who did not receive post-operative thyroid hormone treatment and 7 per cent (5/73 cases) in those with treatment (p < 0.001). In the group of patients without post-operative thyroid hormone treatment, for both the group of patients with adenoma and that with nodular goitres, the recurrence was found to occur as late as more than 10 years after surgery.

Presence of autoimmunity to pancreatic antigens in a patient with fibrocalculous pancreatic diabetes.

A case of fibrocalculous pancreatic diabetes (FCPD) is reported for which antibody and cellular immune characteristics were determined. The patient, a Thai woman, had serum islet cell antibodies (ICA) that were detected by both immunoperoxidase staining and an indirect enzyme-linked immunosorbent assay (ELISA). Serum anti-human insulin antibodies were negative by a displacement ELISA. Lymphoproliferation assay against pancreatic antigen prepared from a blood group O cadaveric donor was positive. Increased CD8+ lymphocytes were observed using direct immunofluorescence staining and flow cytometry. CD4+ T lymphocytes, B lymphocytes and NK cells were within normal levels. These findings provide evidence for autoimmunity to pancreatic antigens in a patient with fibrocalculous pancreatic diabetes.