Thyroid Auto-Antibodies

Serum thyroglobulin and its autoantibody following subtotal thyroid resection of Graves' disease

Thyroid surgery leads to marked changes of the levels of serum thyroglobulin and its autoantibodies in the subsequent 3 postoperative weeks. Furthermore in Graves' disease progression of exophthalmos has sometimes been seen following thyroidectomy. Nineteen medically pretreated patients with Graves' disease and no signs of exophthalmos were studied systematically up to 6 months postoperatively. Nine patients had thyroglobulin antibodies. Mean values rose to 3.5 times pretreatment values within 2 months (P less than 0.001) followed by a gradual fall below pretreatment level after 6 months. None of the antibody negative patients reverted to positive or vice versa. Serum thyroglobulin (n = 10) was elevated preoperatively (mean 309 micrograms/l, SD 251), their values being normalized within 1-2 months (mean 19.4 micrograms/l, SD 7.3). The preoperative serum thyroglobulin correlated to the weight of the removed thyroid tissue (r = 0.87, P less than 0.01). Three patients showed elevated thyroid stimulating hormone after 1 month. Of these, two developed myxoedema, the third remained euthyroid with persistently elevated serum thyroglobulin. None showed recurrence or developed exophthalmos within the period of observation. In spite of rising levels of thyroglobulin antibodies in all patients with antibodies none developed exophthalmos and only one patient with thyroglobulin antibodies had clinical myxoedema.

Hypothyroidism following 131I therapy for hyperthyroidism in relation to immunologic parameters

A series of 191 patients with hyperthyroidism treated with 131I was examined for the presence of antibodies to thyroid cytoplasmic antigen and to thyroglobulin before and after therapy, and followed up for 12 years. Patients with thyroid antibodies before therapy had a significantly higher incidence of hypothyroidism than those without demonstrable antibodies (p less than 0.01). A higher incidence of hypothyroidism occurred in the presence of antibodies to thyroid cytoplasmic antigen than to thyroglobulin. Patients without demonstrable antibodies to thyroid cytoplasmic antigen before the therapy and who afterwards developed such antibodies had a significantly higher incidence of hypothyroidism than those who remained seronegative (p less than 0.01).

DNA-synthesis of lymphocytes in hyperthyroid and euthyroid subjects. Effect of 131I therapy on hyperthyroidism

The DNA-synthesis of human lymphoid cells as estimated by the measurement of thymidine incorporation in vitro was investigated in healthy controls and in patients with various thyroid disorders before and after therapy. Hyperthyroid patients treated with 131I and surgery (euthyroid at initial blood sampling before surgery), patients with atoxic nodular goitre treated by surgery and healthy untreated control individuals comprised the material. The synthesis of DNA in lymphocytes was higher in hyperthyroid patients in comparison with euthyroid individuals, and decreased subsequent to 131I therapy in the hyperthyroid patients. No decrease was recorded in the other groups of patients. No evidence suggesting a change in the lymphocyte reactivity to thyroglobulin was found in any of the patient groups.