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Changes in thyroid function and immunological parameters long after subtotal thyroidectomy for Graves' disease.

AbstractOBJECTIVE:
To find out whether subtotal thyroidectomy results in long term stable functional and immunological remission in patients with Graves' disease.
DESIGN:
Retrospective study.
SETTING:
Teaching hospital, Japan.
SUBJECTS:
176 patients who underwent subtotal thyroidectomy for Graves' disease, 1970-79.
INTERVENTION:
Follow up surveys in 1984 and 1992.
MAIN OUTCOME MEASURES:
Changes in thyroid function, antibody titres, and lymphocyte subsets.
RESULTS:
29/79 patients (39%) who were euthyroid in 1984 had evidence of thyroid dysfunction in 1992. Of the 8 patients with latent hypothyroidism in 1984, 3 (38%) had become euthyroid by 1992, and none required treatment. Of the 29 patients who were hypothyroid in 1984, 5 had latent hypothyroidism and 1 was euthyroid in 1992, and of the 18 patients with recurrent hyperthyroidism in 1984, 1 had become euthyroid by 1992. The number of positive titres to TSH-binding inhibitory immunoglobulin was significantly higher in the recurrence group (31/36, 86%) compared with the hypothyroid (7/26, 27%), latent hypothyroidism (8/37, 22%), and euthyroid (22/77, 29%) groups (p < 0.01). There were also significant differences in the mean (SD) number of Leu HLA DR subsets between the control (17 (3), n = 18) and recurrence (21 (6), n = 38), hypothyroid (22 (6), n = 35), latent hypothyroidism (22 (6), n = 22), and euthyroid (22 (9), n = 64) groups (p < 0.002). There were no differences in the number of T cell subsets among the groups.
CONCLUSION:
Treatment of Graves' disease by subtotal thyroidectomy does not necessarily result in stable late functional or immunological remission. Long term follow up of such patients may be necessary.
AuthorsY Kasuga, S Kobayashi, M Fujimori, K Shingu, K Asanuma, Y Hama, K Ito, M Maruyama, J Amano
JournalThe European journal of surgery = Acta chirurgica (Eur J Surg) Vol. 164 Issue 3 Pg. 173-8 (Mar 1998) ISSN: 1102-4151 [Print] England
PMID9562276 (Publication Type: Journal Article)
Chemical References
  • Antigens, CD
  • Autoantibodies
  • Immunoglobulins, Thyroid-Stimulating
  • Receptors, Thyrotropin
  • Thyroid Hormones
  • thyrotropin-binding inhibitory immunoglobulin
  • Thyroglobulin
Topics
  • Antigens, CD (blood)
  • Autoantibodies (analysis)
  • CD4-CD8 Ratio
  • Case-Control Studies
  • Chi-Square Distribution
  • Data Collection
  • Female
  • Follow-Up Studies
  • Graves Disease (immunology, surgery)
  • Humans
  • Immunoglobulins, Thyroid-Stimulating
  • Male
  • Prognosis
  • Receptors, Thyrotropin (analysis)
  • Recurrence
  • Retrospective Studies
  • T-Lymphocyte Subsets (cytology)
  • Thyroglobulin (immunology)
  • Thyroid Function Tests
  • Thyroid Hormones (blood)
  • Thyroidectomy

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