Endocrine Abstracts

Aim: Most research teams analyze the evolution of patients with Hashimoto thyroiditis (HT) on syndromal basis, not on pathogenetic basis. Thus, most researchers refer to thyroid function evolution. In this study we tried to show how evolve the antithyroid antibodies. Therefore, we analyzed ATPO evolutive patterns.

Method: (1) ATPO levels were analyzed in several accreditated Bucharest laboratories. (2) Only patients with minimum 3 investigations were considered for interpretation. (3) We considered 5 ATPO evolutive patterns: (a) undulatorious; (b) decreasing; (c) increasing; (d) unmodified, (e) disappearance. (4) Unmodified pattern was considered if ATPO level did not differed by 5%. (5) Disappearance pattern was considered if ATPO decreased under the cut off level (=34 ui/ml).

Results: (A) Patients: 450; women – 421, men – 29 (6.89%). (B) The reinvestigation final time was: average: 5.37 years; median: 4.75; minimum: 2 months, maximum: 22 years. (C) ATPO level at onset (diagnostic time): average: 854 ui/ml, standard deviation: 2508. (D) The evolution patterns were: (a) undulatorious – 313 patients (69.5%); 5 without thyroid; (b) decreasing (ATPO over cut off limit) – 76 (17%); 3 no thyroid (1 – atrophy, 2 thyroidectomy/TX); (c) increasing: 36 (8%); (d) unmodified: 12 (2.67%), 2 no thyroid (1 after 131-I, 1 TX); (e) disappearance: 13 patients (2.9%), 8 no thyroid (3 atrophy, 5 TX). (E) ATPO patterns in patients (no. 68) seen after 10 years: (a) undulatorious: 51 (75%); (b) decreasing: 11 (16%); increasing: 1; unmodified: 1; (e) disappearance: 4 (6%). (F) There was no clear correlation with thyroid function at onset: Hypothyroidism vs euthyroidism vs hyperthyroidism: (a): 153-113-47; (b): 31-30-15; (c): 16-13-7; (d): 3-7-2; (z test, P>0.005); (e): 13-0 – significant difference.

Conclusions: (1) In most patients (c. 70%), ATPO evolve undulatorious. (2) When thyroid is missing, ATPO decreased level were registered till disappearance.