THE VALUE OF THYROID AUTOANTIBODIES IN NON-TOXIC GOITRE
OSMAN ARTUNÇ1, İRFAN COŞKUN2
1Hava Hastanesi Genel Cerrahi Anabilim Dalı, Etimesgut/ANKARA
2Trakya Üniversitesi Tıp Fakültesi, Genel Cerrahi Anabilim Dalı, EDİRNE
Abstract
TGI and thyroid autoantibodies may play a role in the etiology of nontoxic goitre. Studies have shown that most non-toxic goitre patients have a variant of the autoimmune diseases of the thyroid which is separate from lymphocytic thyroditis. A study was undertaken to define the role of autoantibodies in the etiology of non-toxic goitre. The effects of thyroidectomy on thyroid functions were also examined and the important points for postoperative hormonal replacement evaluated.
Twenty-nine patients with diffuse, nodular and muttinodular goitre and 12 normal controls were taken into the study in Gülhane Military Academy, Department of General Surgery during 1986 and 1987. Unilateral or bilateral subtotal thyroidectomy was carried out in 27 patients while two had nodular extirpation only. Thyroid hormone levels and TSH values were measured before the operation and on the 1st, 3rd and 6th months postoperatively. Lymphocytic infiltration was measured in the thyroidectomy specimens and thyroid autoantibodies were searched in the patients sera. Thyroid functions and variations in TSH in both groups were compared statistically.
In operated cases, postoperative TSH and TT4 levels had increased and T3 U had decreased compared to the controls. Thirteen patients (45%) had decreased while 7 patients (20.4%) had increased lymphocytic infiltration in the resected specimens. Three patients (10%) had thyroglobulin antibodies, while 5 (77%) had microsomal antibodies and 12 (40%) had nucleoprotein antibodies.
Elevated TSH levels were found in patients with both multinodular goitre and autoantibodies and in those with hypothyroidism. Replacement therapy was begun on the 3rd postoperative month in patients having high lymphocytic infiltration and whenever hypothyroidism developed in other patients. TSH levels and other thyroid parameters returned back to normal following replacemenf therapy.
It is concluded that autoantibodies play an important role in etiology of non-toxic goitre and that replacement therapy is needed in patients following surgical resection for no-toxic goitre whenever autoantibodies and high levels of lymphocytic infiltration are detected.