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Recovery Of Thyroid Function With A Decreased Titre Of Antimicrosomal Antibody In A Hypothyroid Man With Hashimoto’s Thyroiditis

Yamamoto et al., 1983Other/Unknown

Acta Endocrinologica 102: 1983; 531-534

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Abstract

A 36-year-old man with diffuse goitre, signs of mild hypothyroidism, strikingly low levels of T-4 (0.9 micrograms/dl) and T3 (24 nanograms/dl), elevated TSH (140 microU/ml) and elevated microsomal haemagglutination antibody (MCHA, 1:409,600), subsequently became nongoitrous and euthyroid with a decreased titre of antimicrosomal antibody without any medication. At the time of surgical biopsy, serum levels of T4 and T3 had risen to the normal range (4.6 micrograms/dl and 73 nanograms/dl, respectively), serum TSH had decreased to 30 microU/ ml and the titre of MCHA to 1:25,600. Thyroid specimens showed Hashimoto’s thyroiditis. The activity of thyroid peroxidase (TPO) was normal. The latest examination, 1 year and 3 months after initial evaluation, showed that the patient remained euthyroid with no goitre, that serum thyroid hormones were within the normal range (T4 7.7 micrograms/dl and T3 97 nanograms/dl), and that TSH was not detectable. The titre of MCHA decreased strikingly to 1:400.

Case Details

Personal Characteristics

A 36-year-old man with diffuse goitre, signs of mild hypothyroidism, strikingly low levels of t-4 (0.9 micrograms/dl) and t3 (24 nanograms/dl), elevated tsh (140 microu/ml) and elevated microsomal haemagglutination antibody (mcha, 1:409,600)

Clinical Characteristics

Swelling at the front of the neck, hoarseness and oedema of the face, slightly enlarged thyroid gland was diffuse, symmetrical and firm

Remission Characteristics

Became nongoitrous and euthyroid with a decreased titre of antimicrosomal antibody without any medication

Treatment & Mechanisms

Proposed Remission Mechanisms

Not discussed

Clinical Treatment

L-thyroxine (125 micrograms/day)

Additional Notes

Two of his relatives had Graves’ disease. At the time of surgical biopsy, serum levels of T4 and T3 had risen to the normal range (4.6 micrograms/dl and 73 nanograms/dl, respectively), serum TSH had decreased to 30 microU/ ml and the titre of MCHA to 1:25,600. Thyroid specimens showed Hashimoto’s thyroiditis. The activity of thyroid peroxidase (TPO) was normal. The latest examination, 1 year and 3 months after initial evaluation, showed that the patient remained euthyroid with no goitre, that serum thyroid hormones were within the normal range (T4 7.7 micrograms/dl and T3 97 nanograms/dl), and that TSH was not detectable. The titre of MCHA decreased strikingly to 1:400.