Endocrine Abstracts

Aim: Most research teams analyze the evolution of patients with Hashimoto thyroiditis (HT) on syndromic basis (e.g., the thyroid function), not on pathogenic basis (the autoantibodies). Thus, most researchers refer to thyroid hormone evolution. In this study we re-analyzed (first in 2018) how evolve the antithyroid autoantibodies. Therefore, we analyzed the antithyroperoxydase antibodies (ATPO) evolutive patterns in patients with HT.

Method: 1. ATPO levels were analyzed in several accredited 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. normalization. 4. Unmodified pattern was considered if ATPO level did not differed by 5%. 5. normalization pattern was considered if ATPO decreased under the cut off level (= 34 IU/ml).

Results.

A. All Patients: 893; women – 831, men –62 (7.46%).

B. Patients re-evaluated over 10 years: 97; woman: 89; men: 8 (8.99%).

C. The reinvestigation final time for all patients: average: 4.28 years; median: 3; minimum: 2 months, maximum: 24.5 years.

D. For patients with over 10 years observation; average: 12.56 years; median: 12; minimum: 10 years, maximum: 24.5 years

E. ATPO level at onset (at diagnostic time) for all patients re-analyzed: average: 789.55 IU/ml, standard deviation: 2129.

F. For patients observed over 10 years: average; 607.86 IU/ml, S.D.: 941.

G. The evolution patterns for all patients: a. undulatorious – 425 patients (47.59%); 12 without thyroid (3 = TXT/total thyroidectomy, 3 = 131-I, 6 = atrophy); b. decreasing but with ATPO over the cut off limit – 233 (26.09%); 6 without thyroid (3 = atrophy, 2 = TXT, 131-I = 1); c. increasing: 156 (17.47%); 1 = TXT; d. unmodified: 58 (6.49%), 2 no thyroid (1 = 131-I, 1 = TXT); e. normalization: 21 patients (2.35%), 5 no thyroid (2 = atrophy, 3 = TXT).

H. ATPO patterns in patients seen after 10 years observation: a. undulatorious: 76 (78.35%), vs all, P << 0.001; b. decreasing: 14 (14.43%), vs all, P << 0.001; increasing: 1 (1.03%); unmodified: 1 (1.03%); e. normalization: 5 (5.15%).

Conclusions: 1. When performed more ATPO analysis (over 10 years), the evolutive pattern become undulatorious, around 80% patients. 2. When thyroid is missing, ATPO decreased level were registered till normalization.