Abstract | OBJECTIVE: 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: 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.
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Authors | Y Kasuga, S Kobayashi, M Fujimori, K Shingu, K Asanuma, Y Hama, K Ito, M Maruyama, J Amano |
Journal | The European journal of surgery = Acta chirurgica
(Eur J Surg)
Vol. 164
Issue 3
Pg. 173-8
(Mar 1998)
ISSN: 1102-4151 [Print] England |
PMID | 9562276
(Publication Type: Journal Article)
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Chemical References |
- Antigens, CD
- Autoantibodies
- Immunoglobulins, Thyroid-Stimulating
- Receptors, Thyrotropin
- Thyroid Hormones
- thyrotropin-binding inhibitory immunoglobulin
- Thyroglobulin
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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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