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PubMed1998

[Thyroid function and autoimmunity in 215 patients seropositive for the hepatitis C virus].

The aim of this study was to estimate thyroid function and the prevalence of thyroid antibodies among HCV seropositive patients. We undertook a screening for thyroid dysfunction, and antithyroperoxidase (ATPO) and antithyroglobulin (ATG) antibodies, in 215 HCV seropositive patients referred for hepatologic consultation, 118 males and 97 females, mean age 44 +/- 14 years, range 16-80 years. No patient was treated with interferon and all were seronegative for HIV. Eighteen patients (8%) had antithyroid antibodies, 12 with ATPO antibodies (5.6%) and 10 with ATG antibodies (4.7%). Four patients had both ATPO and ATG antibodies (1.8%), one case of Graves' disease and 3 cases of autoimmune hypothyroidism found during this study. Five patients (2.3%) had hyperthyroidism, three cases of Graves' disease, one case of iodine load and a case of Grave's disease incidentally diagnosed during medical examination. Eleven patients (5.1%) had hypothyroidism, one case already known and treated without antithyroid antibodies, 4 cases of autoimmune etiology (3 diagnosed in consultation and one already known and compensated hypothyroidism), one case of amiodarone-induced hypothyroidism discovered during this study, 5 cases of hypothyroidism without antibodies (two cases of compensated hypothyroidism with normal TRH stimulating test, two cases with severe liver cirrhosis and one case with chronic hepatitis). Twelve patients had antithyroid antibodies with normal TSH levels. The prevalence of ATPO and ATG antibodies in our study is similar to the prevalence usually observed in general population and does not suggest a pathogenic role of HCV in autoimmune thyroid disorders.

Adolescent↗
PubMedDate not supplied

[Cytochemical markers for intracellular glycogen in peripheral blood neutrophils in patients with gingivitis presenting with thyroid gland disorders, and after treatment with antioxidants].

Used in this paper is the material secured in the examination of 82 children aged 11 to 14 years old presenting with thyroidal dysfunction, who had come from ecologically abnormal zones and placed on a rehabilitative treatment programme in the Eupatoriya sanatorium "Druzhba". Our objective in this work was to study effects of antioxidant therapy on parameters associated with intracellular glycogen in patients with gingivitis in the presence of a concomitant illness. The data obtained permitted coming to the conclusion that development of gingivitis is of a manifest energy-intensive character, with a concurrent morbid medical condition being an aggravating factor. The use of antioxidant therapy in a combined treatment of the above category stomatological patients was found to shorten time they receive their treatment. Other positive effects of the above therapy include prevention of complications and activation of glycogen-producing function of homeostasis.

Adjuvants, Immunologic↗
PubMed1986

Reversibility of severe hypothyroidism with supplementary iodine in patients with endemic cretinism.

The reversibility of thyroid dysfunction in children with endemic cretinism treated with supplemental iodine is unknown. To study this question we conducted a five-month follow-up of 51 patients with cretinism (age 14 and below), who were randomly assigned to treatment (0.5 ml of intramuscular iodized oil) and control groups. The geometric mean initial serum level of thyrotropin (223 microU per milliliter; SD, 97 to 513) and the mean (+/- SD) initial serum level of thyroxine (1.0 +/- 1.2 micrograms per deciliter) indicated that all patients had severe hypothyroidism. Within one month after receiving the iodized oil, 13 of 14 of the younger patients (less than 4 years) and 1 of 9 of the older patients (4 to 14 years; P less than 0.001) had thyrotropin values below 20 microU per milliliter. Five months after treatment, the levels of thyrotropin had decreased and those of thyroxine had increased in all children, but greater changes occurred in the 13 younger patients than in the 14 older patients. The mean levels of thyrotropin were 2 microU per milliliter (SD, 0.6 to 6) vs. 38 microU per milliliter (SD, 11 to 132; P less than 0.001), and the mean (+/- SD) levels of thyroxine were 13.1 +/- 2.8 vs. 8.1 +/- 4.6 micrograms per deciliter (P less than 0.001). In the untreated group, 3 of the 9 younger patients and none of the 15 older patients recovered normal thyroid function within five months. We conclude that iodine supplementation restored a biochemically euthyroid state in all younger children with cretinism but only some of the older children. In addition, some younger patients became euthyroid without iodine supplementation.

Adolescent↗
PubMed2002

The role of thyroid hormone in blood pressure homeostasis: evidence from short-term hypothyroidism in humans.

Arterial hypertension is known to be frequently associated with thyroid dysfunction, with a particularly high prevalence in chronic hypothyroidism. However, to our knowledge no comprehensive study addressed causal mechanisms possibly involved in this association. We here report the physiological relationships between blood pressure and neuro-humoral modifications induced by acute hypothyroidism in normotensive subjects. Twelve normotensive patients with previous total thyroidectomy were studied. Ambulatory 24-h blood pressure monitoring was performed, and free T(3), free T(4), TSH, PRA, aldosterone, cortisol, adrenaline, and noradrenaline were assayed 6 wk after oral L-T(4) withdrawal (phase 1) and 2 months after resumption of treatment (phase 2). During the hypothyroid state (TSH, 68.1 +/- 27.7 microIU/ml; mean +/- SD), daytime arterial systolic levels slightly, but significantly, increased (125.5 +/- 9.7 vs. 120.4 +/- 10.8 mm Hg; P < 0.05), and daytime diastolic levels (84.6 +/- 7.9 vs. 76.4 +/- 6.8 mm Hg; P < 0.001), noradrenaline (2954 +/- 1578 vs. 1574 +/- 962 pmol/liter; P < 0.001), and adrenaline (228.4 +/- 160 vs. 111.3 +/- 46.1 pmol/liter; P < 0.05) also increased. PRA remained unchanged (0.49 +/- 0.37 vs. 0.35 +/- 0.21 ng/ml.h; P = NS), whereas both aldosterone (310.3 +/- 151 vs. 156.9 +/- 67.5 pmol/liter; P < 0.005) and cortisol (409.2 +/- 239 vs. 250.9 +/- 113 pmol/liter; P < 0.02) significantly increased. By using univariate logistic regression daytime arterial diastolic values, noradrenaline and aldosterone were found to be significantly related to the hypothyroid state (P < 0.02, P < 0.036, and P < 0.024, respectively). In conclusion, our data show that thyroid hormones participate in the control of systemic arterial blood pressure homeostasis in normotensive subjects. The observed sympathetic and adrenal activation in hypothyroidism, which is reversible with thyroid hormone treatment, may also contribute to the development of arterial hypertension in human hypothyroidism.

Adrenal Glands↗
PubMed1995

A quick method to detect circulating anti-thyroid hormone autoantibodies.

The aim of this study was to evaluate the feasibility of a chromatographic method to easily detect circulating anti-thyroid hormone autoantibodies (THBA), to calculate their affinity constant and the total thyroid hormone (TH) levels in presence of THBA. This method was applied to sera from 4 subject with suspected THBA and 20 controls (10 normal subjects and 10 patients with thyroid dysfunctions). After a short incubation with 125I-T3 or T4 tracer solution containing 8-anilino-1-naphthalenesulfonic acid as inhibitor of the binding of TH to plasma proteins without affecting THBA binding, the samples were chromatographied on prepacked Sephadex LH 20 columns and eluted with TRIS buffer to separate free TH from THBA-bound TH. Samples were considered THBA positive when radioactivity values in TRIS eluates were higher than in controls. THBA-bound TH were subsequently eluted with methanol and used to calculate the total TH present in patients with THBA. After a validation test using two standardized methods, we propose this method to quickly detect TH-BA in samples with suspected spuriously high values of free and total TH.

Anilino Naphthalenesulfonates↗
PubMed2006

Effect of the 2004 mid niigata prefecture earthquake on patients with endocrine disorders.

A major earthquake (Richter scale magnitude 6.8) struck the Chuetsu district of Niigata Prefecture, Japan, a rural area with mountain villages, on October 23, 2004. Strong aftershocks (Grade 5-6 on the Japanese intensity scale, JIS) continued for 2 months. We analyzed the earthquake's impact on 229 patients with various endocrine disorders [6 central diabetes insipidus (CDI), 16 adrenal insufficiency (AI) including 5 panhypopituitarism, 10 ACTH isolated deficiency and 1 Addison's disease, 145 Graves' disease and 62 Hashimoto's disease]. The status of patients with CDI or AI was not adversely affected by the earthquake. Twenty-eight (19%) patients with Graves' disease developed more severe hyperthyroidism; the incidence of developing more severe hyperthyroidism increased with greater degrees of hyperthyroidism. Three (5%) patients with Hashimoto's disease developed increased TSH concentrations. Most patients stayed in their own houses following the first shock. The median PTSD total score for all patients was low. However, the PTSD total score in patients with CDI or Hashimoto's disease was significantly higher than in other patients, while the subscore of mental status in patients with AI was significantly much lower than in other patients. In patients with Hashimoto's disease, patients whose hypothyroidism worsened had higher total and environmental effects score than patients whose hypothyroidism remained stable. Comparing patients whose hyperthyroidism became more severe to those in whom it remained stable, as well as on multiple logistic regression analysis, serum TRAb was found to be a risk factor for developing more severe hyperthyroidism. In conclusion, our findings indicate that Graves' disease patients need to maintain their euthyroid state with a low serum TRAb titer to prevent the development of further thyroid dysfunction after an earthquake, and that all patients should continue to take their medication, since it is likely that their lives will be interrupted by environmental effects owing to earthquake-shock, especially patients with CDI or Hashimoto's disease. Due to the risk of medical facility closure during a disaster, all patients should always have a note or copy of their medical records, including medical history and medications used, to avoid relying on patients remembering their drug names and doses. Furthermore, appropriate information should be provided by all means possible, including the mass media, to affected individuals, particularly those with AI, to decrease the occurrence of adverse consequences.

Adrenal Gland Diseases↗
PubMed1990

[A long-term follow-up study of patients with goitrous Hashimoto's disease--prognosis and its predictive factors].

To clarify the clinical course and prognosis in patients with Hashimoto's disease, thyroid function was examined in 199 patients (166 females, 33 males) about every six months for an average of 10.5 years in females and 7.5 years in males. The diagnosis of Hashimoto's disease was based on the presence of diffuse goiter, positive thyroid autoantibodies (antimicrosomal antibodies greater than or equal to 400 and/or antithyroglobulin antibodies greater than or equal to 100) and/or the typical histological findings of Hashimoto's disease in aspiration biopsy. Initially, 76 patients (38%) were euthyroid, and 123 patients (62%) were subclinical hypothyroid or overt hypothyroid. At the end of follow-up, 113 patients (57%) were euthyroid and 86 patients (43%) were permanently hypothyroid. Only 12 patients (6%) in the initially euthyroid state developed permanent hypothyroidism during the follow-up period. Transient thyroid dysfunction occurred in 35 (46%) of 76 patients who were initially euthyroid. Forty-nine (40%) of 123 patients who initially had subclinical or overt hypothyroidism were in the euthyroid state at the end of follow-up. In these recovered patients, the T3/T4 ratio and the level of T3 was higher than in non-recovered patients. The best predictive factors of final permanent hypothyroidism at the initial examination were 1) the titer of antithyroglobulin antibodies greater than or equal to 6400, 2) the titer of antimicrosomal antibodies greater than or equal to 25600, 3) age above 50 years, 4) a stony-hard goiter. Female patients who initially show three of the above predictive factors and males who show two have a high possibility of being permanently hypothyroid after 10 years. The prognosis is poorer in male than in female patients.

Female↗
PubMedDate not supplied

The late endocrine effects of childhood cancer treatment.

Whilst many children diagnosed with cancer can now realistically hope for long term survival, the consequences of cancer treatment can be particularly devastating as they enter adolescence and adulthood. Disruption of the endocrine system can result from such treatment, including growth hormone deficiency, problems in normal pubertal progression and thyroid dysfunction. Fertility can also be affected by cancer treatment received as a child, which can have a devastating impact as the patient enters adulthood. In addition, these children may encounter disorders of growth and bone metabolism due to both their initial disease and aspects of its treatment, resulting in further morbidity in later life. The aetiology and diagnosis of these problems are discussed in this review, along with therapeutic options in order to reduce their impact. Long term follow up and clinical vigilance in this patient group is vital. We must continue to strive towards improved survival from childhood cancer, but equally we must remain aware of the adverse effects of treatment, particularly in the long term, and must aim to reduce the impact of these effects as children enter adolescence and adult life.

Bone and Bones↗
PubMed2001

Dehydroepiandrosterone sulphate and corticotropin levels are high in young male patients with conduct disorder: comparisons for growth factors, thyroid and gonadal hormones.

Childhood conduct disorder (CD) may originate in a stressful upbringing, and be associated with unusual physical or sexual development and thyroid dysfunction. We therefore explored circulating levels of hormones from adrenal, gonadal and growth hormone axes associated with stress, aggression and development in 28 CD patients and 13 age-matched healthy children (10-18 years old). The CD group had higher levels of dehydroepiandrosterone sulphate (DHEA-S), corticotropin (ACTH) and free tri-iodothyronine (fT(3)) if under 14 years. There were no differences for gonadal hormones or maturity ratings which were not associated with aggression. Smaller physical measures in CD children correlated with DHEA-S and growth factors (e.g. insulin-like growth factor I) increased ACTH and fT(3) correlated with restless-impulsive ratings, and DHEA-S with 'disruptive behaviour'. Imbalances in the adrenal and growth axes may have neurotropic repercussions in development.

Adolescent↗
PubMed1998

Endocrine late effects in children who underwent bone marrow transplantation: review.

With the increasing use and success of BMT, larger numbers of children survive transplantation. Still, cancer treatment in children causes damage to the endocrine glands, often inducing growth deficiency, pubertal delay and thyroid dysfunction. This paper will deal with some of the most common endocrine disorders related to BMT in the pediatric population. Irradiation is the major contributor for growth impairment after BMT, acting through lesion to epiphyseal growth-plate, gonadal damage with delayed or precocious puberty, hypothyroidism, and growth hormone insufficiency. Gonadal dysfunction can be induced both by a direct injury to the gonads (irradiation, gonadotoxic agents) causing primary hypergonadotropic-hypogonadism, and with less frequency, by neuroendocrine injury to the hypothalamo-pituitary axis causing hypogonadotropic-hypogonadism. It seems that both doses of chemotherapy and of irradiation used by different regimens, fractionation of irradiation, and age at the time of BMT are the most important factors when we deal with toxic endocrine late-effects in long term survivors. In order to improve the quality of life of each single patient who receive BMT, and without inflicting the success-rate of this procedure, we recommend a life-long surveillance to prevent or to treat symptoms and disorders caused by hormone deficiencies, and we also advocate for a multidisciplinary team-approach that includes an endocrinologist consultant.

Bone Marrow Transplantation↗
PubMed1976

Role of thyroid hormones in an abnormal grooming behavior in thyroidectomized cats and cats with pontile lesions.

Thyroidectomized cats and cats with pontile lesions exhibit the same abnormal grooming behavior. Investigations were conducted to determine whether the abnormal grooming behavior in cats with pontile lesions was attributable to a hypothyroid condition. Administration of thyroid hormones abolished the abnormal behavior of thyroidectomized cats but was without effect in cats with pontile lesions. Studies of brain and blood levels of thyroid hormones in cats with pontile lesions failed to detect any differences from normal cats, and normal effects of thyroid hormones on evoked potentials to light flashes and to clicks were obtained in cats with pontile lesions. It was concluded that any thyroid dysfunction that may exist in the cats with pontile lesions was not involved in the genesis of the abnormal grooming behavior. Because the abnormal grooming behavior fluctuates rhythmically during the year, an endocrine hypothesis was entertained as the source of the fluctuations; endocrine concomitants of the abnormal behavior were investigated with longitudinal studies. The urinary excretion of 11-hydroxycorticoids exhibited a significant negative correlation with the abnormal behavior. When compared with that of normal cats, the plasma level of 11-hydroxycorticoids of thyroidectomized cats was significantly decreased. Intramuscular injections of 11-hydroxycorticoids abolished the abnormal behavior in both thyroidectomized cats and cats with pontile lesions. These results considered together with previous findings indicate that thyroidectomy and pontile lesions induce similar changes in 11-hydroxycorticoid and serotonergic functions-changes that are critical features of the physiological bases of the abnormal grooming behavior in both groups.

11-Hydroxycorticosteroids↗
PubMed1997

Endocrine late effects of childhood cancers.

Long-term survival in children with cancer has increased markedly in the past 15 years. However, impaired linear growth and thyroid dysfunction that vary according to the age at diagnosis and treatment and to the dose and duration of radiation and chemotherapy have been described in these patients. The impact of cranial irradiation on the hypothalamic-pituitary-adrenal axis and on pubertal maturation has been less well studied. A positive correlation between the age at diagnosis and the age at onset of puberty in children who have been treated with high-dose cranial radiation therapy for central nervous system (CNS) tumors has been found recently. Frank adrenal insufficiency is uncommon after high-dose CNS irradiation, but alterations in the hypothalamic-pituitary-adrenal axis do occur. Assessments of the effects of newer modes of radiation therapy such as hyperfractionated craniospinal radiation suggest a lower incidence of primary hypothyroidism in the long term.

Adolescent↗
PubMed1991

Are there clinical and epidemiological differences between familial and non-familial Alzheimer's disease?

To determine whether there are clinical and epidemiological differences between familial and non-familial Alzheimer's disease, we studied 151 patients with the clinical diagnosis of Dementia of the Alzheimer Type (DAT). Eighty-four index patients (56%) had at least one relative with reported DAT-type memory loss; the remaining 67 did not. For comparison, patients with a positive family history were grouped into a suspected familial DAT (FDAT), and those with a negative family history were grouped into a suspected non-familial DAT (NFDAT). There were no significant differences between FDAT and NFDAT patients with respect to age of symptom onset, survival time, rate of cognitive decline, motor function, behavioral signs or symptoms, head trauma, thyroid dysfunction, maternal age, or birth order. There were no significant differences between pedigrees of FDAT and NFDAT patients in respect to the prevalence of Down's syndrome or age of mortality. To examine a more "familial" set of FDAT patients, an FDAT subgroup (F2DAT) consisting of 33 index patients with two or more affected relatives with DAT-type memory loss was compared to the 67 NFDAT patients in a similar analysis. No significant differences were found. However, NFDAT index patients had a higher reported prevalence of head trauma than those patients in the F2DAT subgroup (NFDAT 22%, F2DAT 7%, OR = 4.2, CI = 0.9-20.0, P = 0.08). Thus severe head trauma may be a more important etiological factor in the non-familial form of DAT. To better examine this tendency, future studies should be conducted utilizing a larger number of pedigrees and familial criteria which account for the number of persons at risk and the age at onset of disease.

Aged↗
PubMed2005

Thyroid ophthalmopathy.

Thyroid associated ophthalmopathy (TAO) is an inflammatory orbital disease of autoimmune origin with the potential to cause severe functional and psychosocial effects. It presents one of the most difficult challenges in the clinical practice of ophthalmology. Pathogenesis of the disease is not yet fully understood. It is usually associated with thyroid dysfunction. TAO has a variable clinical presentation; it may cause severe damage to vision and orbital architecture. TAO is the most frequent cause of unilateral or bilateral proptosis in adults. Potential sight-threatening complications include optic neuropathy and severe corneal exposure keratopathy. Most patients do not require specific therapy. Those with moderately severe or severe disease are treated with steroids and/or orbital radiation during the inflammatory phase and surgical therapy during the inactive phase. Decompression may be needed in either phase. Although appropriate treatment can restore near normal function and appearance in most cases, the management of TAO is difficult, controversial, and far from optimal. Disease severity is the key determinant of the indication for therapy, while therapeutic choice depends on inflammatory activity. Clinical management is difficult because no immediate or dramatic cure exists. With appropriate medical and surgical treatment, patients can be restored to normal function and appearance in most cases, but the process to reach this goal will usually be lengthy.

Diagnosis, Differential↗
PubMed2003

Assisted reproduction and thyroid autoimmunity: an unfortunate combination?

The association between positive thyroid antibodies and an increased miscarriage rate in pregnancies after assisted reproduction technology (ART) remains controversial. We wanted to clarify this issue by performing a prospective cohort study in 234 women by systematically screening for thyroid peroxidase antibodies (TPO-Ab), serum TSH, and free T(4)(FT(4)) before the first ART cycle. Women with overt thyroid dysfunction were excluded. Fourteen percent of the cohort had positive TPO-Ab. Baseline characteristics [age, 33 +/- 5 yr; TSH, 1.6 (0.02-4.1) mU/liter; and FT(4), 12.2 (9.1-18) ng/liter] were comparable to those of the 86% of women without antibodies [age, 32 +/- 5 yr; TSH, 1.3 (0.05-3.6) mU/liter; and FT(4), 11.7 (9.5-16.5) ng/liter]. In the antibody-positive group, the pregnancy rate was 53% vs. 43% in the antibody-negative group, with an odds ratio of 0.67 [95% confidence interval (CI) (0.32-1.41); P = not significant]; however within the group that was pregnant, the miscarriage rate was 53% and 23%, respectively, with an odds ratio of 3.77 [95% CI (1.29-11.05); P = 0.016]. The age of the women was an independent risk factor for miscarriage, odds ratio 1.08 [95% CI (1.03-1.15); P = 0.005]. We conclude that women with positive TPO-Ab before the first ART cycle have a significantly increased risk for miscarriage.

Abortion, Spontaneous↗
PubMedDate not supplied

Goiter prevalence in children immigrating from an endemic goiter area in Ethiopia to Israel.

A survey study was performed to assess the prevalence of goiter and thyroid dysfunction in a population of 534 Ethiopian children, one year after arrival in Israel. The overall prevalence of goiter was 43.6%. Children in the age group 1-2 years had the lowest prevalence of goiter (6.7%). A progressive increase in goiter prevalence and size with age was observed, with peak occurrence around puberty for both boys (56.7%) and girls (72.2%). Serum FT4 levels were elevated in 4 children; elevated serum TSH levels (above 4.5 mIU/l) were found in 11 children, all of them had normal FT4 levels. Thus the prevalence of hypothyroidism and hyperthyroidism was 2% and 0.8%, respectively, with an even distribution across the various age groups. All the children were clinically normal. The high prevalence of goiter in this group of Ethiopian children with the low frequency of hypothyroidism may be attributed to the combined effects of food goitrogens and iodine deficiency prevailing in Ethiopia. The standard Israeli diet seems to be adequate in respect to iodine requirements, and no iodine enrichment is needed for children immigrating from Ethiopia.

Adolescent↗
PubMed2006

Developmental toxic effects of chronic exposure to high doses of iodine in the mouse.

Chronic exposure to high doses of iodine induces thyroid dysfunction, but effects of chronic exposure to high amounts of iodine on pregnancy and fetal outcome are uncertain. In the present study, Balb/C mice were given different doses of iodine at the levels of 0 (sterile water), 1,500, 3,000, 6,000, 12,000 and 24,000 micro g/L in drinking water for 4 months, then were mated and the developmental toxicity and teratogenicity were evaluated. An obvious colloid goiter was observed, and serum total thyroxine (TT4) levels increased and serum total triiodothyronine (TT3) levels decreased significantly in dams when iodine dose reached 3,000 micro g/L. Maternal effect was evident by the reduction of average daily food consumption in higher doses of iodine groups. Embryotoxicity and teratogenicity were mainly indicated by the reduced body weight in female fetuses, the decreased number of live fetuses, and the increased incidence of resorptions, and especially skeletal variations. These results suggest that exposure to maternally toxic doses of iodine may have a potential developmental toxic effect.

Animals↗
PubMed1998

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

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: 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.

Antigens, CD↗