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KMID : 0356620080230040245
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Journal of Korean Society of Endocrinology
2008 Volume.23 No. 4 p.245 ~ p.252
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Change in Thyroid Autoantibodies According to the Clinical Course of Painless Thyroiditis Excluding Postpartum Thyroiditis
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Lee Ihn-Suk
Shong Min-Ho
Ro Heung-Kyu
Kim Young-Kun
Ku Bon-Jeong
Jo Young-Suk
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Abstract
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Background: Painless thyroiditis is characterized by painless, destructive inflammation of the thyroid gland.
Although thyroid autoantibodies are frequently detected in patients suffering from this condition, the clinical
significance of these antibodies is not well understood. Therefore, this study was conducted to investigate the
relationship between thyroid function and thyroid autoantibodies in painless thyroiditis according to clinical
course.
Methods: Patients proven to have painless thyroiditis were retrospectively included in this study. We
analyzed their clinical features, thyroid function and titers of thyroid autoantibodies according to clinical
course, which was divided into three phases; thyrotoxic, hypothyroid and recovery.
Results: Of the 21 patients included in this study, 2 were male and 19 were female. During the thyrotoxic
phase, the mean free T4 concentration was 4.03 (2~6.8) ng/mL and the mean concentration of thyroid
stimulating hormone (TSH) was 0.02 (0.01~0.07) U/mL. In addition, the titer of antithyroglobulin antibody and
antithyroid peroxidase antibody was 298 (4.8~995) U/mL and 3318 (0.1~25280) U/mL, respectively during this
phase. During the hypothyroid phase, the mean TSH was 16.3 (4.3-49.5) U/mL and was found to be positively
correlated with the level of free T4 observed during the thyrotoxic phase (r = 0.523, P = 0.031). During the
recovery phase, the titer of antithyroglobulin antibody was significantly reduced to 180 (38~487) U/mL when
compared with the titer taken during the thyrotoxic phase (P = 0.016). Additionally, during the hypothyroid
phase, patients found to have antithyroid peroxidase antibody had a higher titer of TSH than those that did
not (23.9 (6.5~49.5) vs. 11.2 (5.3~18.2) U/mL, P = 0.004).
Conclusion: The titer of free T4 and the presence of antithyroid peroxidase observed during the thyrotoxic
phase were related to the titer of TSH during hypothyroid phase. Additionally, the titer of antithyroglobulin
antibody was significantly reduced during the recovery phase.
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KEYWORD
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autoimmune thyroiditis, anti thyroglobulin antibody, thyroid microsomal antibody
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