Ten-Year Follow-Up Study of Thyroid Function in Euthyroid Patients with Simple Goiter or Hashimoto's Thyroiditis

概要

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In an attempt to study the natural course of Hashimotos thyroiditis and simple goiter, 74 euthyroid patients with Hashimotos thyroiditis and 212 patients with simple goiter were followed for 10 years. In 204 patients with simple goiter (96.2%) it remained as a simple goiter throughout the observation period, whereas 8 patients (3.8%) later had Hashimotos thyroiditis as evidenced by the appearance of circulating thyroid autoantibodies. These 8 patients had HLA typing significantly different from that of control subjects. None of the patients with simple goiter had hyperthyroid Graves disease despite the fact that 17.5% of those patients had mild to moderate exophthalmos with either Moebius sign or von Graefes sign. In contrast, 12 patients with Hashimotos thyroiditis (16.2%) had exophthalmos with Moebius sign and/or von Graefes sign, and 4 of 12 such patients later had hyperthyroid Graves disease. TSH binding inhibitory immunoglobulin was detected in 3 of 4 such patients with hyperthyroid Graves disease. Forty-nine patients with Hashimotos thyroiditis (66.2%) still remained euthyroid but 20 of those (27.0%) turned into hypothyroidism during the 10-year follow-up.(Internal Medicine 34: 371-375, 1995)