Influence of l-thyroxine Administration in Patients with Euthyroid Hashimoto's Thyroiditis

Background: The present study aimed to evaluate the immune suppressive effect of l-thyroxine (LT4) on euthyroid Hashimoto's thyroiditis (HT). HT is the most common form of autoimmune thyroid disease and is characterized by lymphocytic infiltration of the thyroid gland, gradual destruction of the organ, and the production of thyroglobulin antibody (Tg-Ab) and thyroid peroxidase antibody (TPO-Ab). Methods: We examined the effect of 6-month LT4 administration in euthyroid HT patients. Twenty patients with euthyroid HT were enrolled. Ten patients were treated with 100 μg/day LT4 for 6 months. The other 10 were not treated with LT4. Thyroid function tests, thyroid volume, and autoantibody titers were measured before and after the 6-month study period. Results: There was significantly decreased serum TPO-Ab, Tg-Ab, thyroid-stimulating hormone, and increased free T4 levels in the LT4-treated group (860±220 vs. 415±182 mIU/ L, 168±61 vs. 71±43 mIU/L, 2.5±0.3 vs. 0.5±0.1 U/L, and 14.1±0.2 vs. 22.2±0.3 pmol/L, p ＜ 0.05, respectively). In contrast, TPO-Ab and Tg-Ab levels did not change significantly; they were slightly increased in the LT4-untreated patients. Thyroid volume did not differ before and after therapy in both groups. Conclusions: Thus, early prophylactic LT4 treatment might be useful for ameliorating the progression of euthyroid HT autoimmunity. The long-term clinical benefit of LT4 therapy in euthyroid HT is yet to be clarified.

並列關鍵字

L-thyroxine ； Hashimoto's thyroiditis ； Euthyroid

參考文獻

Dayan CM, Daniels GH. Medical progress: Chronic autoimmune thyroiditis. New Eng J Med 1996;335:99-107.

Rieu M, Portos C, Lissak B, Laplanche S, Sambor B, Berrod JL, Fombeur JP. Relationship of antibodies to thyrotropin receptors and to thyroid ultrasonographic volume in euthyroid and hypothyroid patients with autoimmune thyroiditis. J Clin Endocrinol Metab 1996;81:641-645.

Reinhardt W, Paul TL, Allen EM, Alex S, Yang YN, Appel MC, Braverman LE. Effect of L-thyroxine administration on the incidence of iodine induced and spontaneous lymphocytic thyroiditis in the BB/Wor rat. Endocrinology 1988;122:1179-1181.

Schumm-Draeger PM, Fortmeyer HP. Autoimmune thyroiditis - Spontaneous disease models - cat. Exp Clin Endocrinol Diabetes 1996;104:12-13.

Allen EM, Braverman LE. The biobreeding Worcester rat-a model of organ-specifi c autoimmunity. Exp Clin Endocrinol Diabetes 1996;104:7-10.

延伸閱讀

Wu, W. C. (2015). The Effects of Hydroxychloroquine on Thyroid Functions and Anti-thyroid Auto-antibodies in Subjects with Hashimoto’s Thyroiditis [master's thesis, National Taiwan University]. Airiti Library. https://doi.org/10.6342/NTU.2015.01236
Hsu, S. Y., Chang, C. H., Su, M. Y., Wang, H. Z., & Tsai, R. K. (2000). Correlation between Clinical Activity Score and Thyroid Autoantibodies in Patients with Thyroid Ophthalmopathy. The Kaohsiung Journal of Medical Sciences, 16(10), 533-538. https://doi.org/10.6452/KJMS.200010.0533
Ha, T. K., Kim, D. W., Park, H. K., Baek, J. W., Lee, Y. J., Park, Y. M., Kim, D. H., Jung, S. J., & Ahn, K. J. (2016). The Effect of Levothyroxine Discontinuation Timing on Postoperative Hypothyroidism after Hemithyroidectomy for Papillary Thyroid Microcarcinoma. International Journal of Endocrinology, 2016(), 410-415-045. https://doi.org/10.1155/2016/3240727
張雁翔、王佩文（2018）。Post-Operative Risk Stratification and Radioiodine Therapy of Differentiated Thyroid Cancer。核子醫學暨分子影像雜誌，31(3)，151-168。https://doi.org/10.6332/ANMMI.201809_31(3).0005
Onal, E. D., Sacikara, M., Saglam, F., Ersoy, R., & Cakir, B. (2014). Primary Thyroid Disorders in Patients with Endogenous Hypercortisolism: An Observational Study. International Journal of Endocrinology, 2014(), 648-652-170. https://doi.org/10.1155/2014/732736

國際替代計量

Influence of l-thyroxine Administration in Patients with Euthyroid Hashimoto's Thyroiditis

全文下載

主題瀏覽