Hypothyroidism as a Late Sequela in Patients with Graves' Disease Treated with Antithyroid Agents

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Abstract

In 1971, thyroid function was evaluated in 15 unselected patients whose only therapy for diffuse toxic goiter was a course of thionamide drug treatment completed 20-27 yr earlier. One patient was frankly hypothyroid by clinical and laboratory criteria. The remaining 14 patients appeared clinically euthyroid and had a normal serum thyroxine (T4) concentration and thyroid radioiodine uptake (RAIU). Nevertheless, only 6 of 14 appeared to be entirely normal according to more refined criteria. The serum thyrotropin (TSH) concentration was markedly elevated in one patient and above the normal range (1.6±2.0; mean±2 SD) in five others. Thyroid stimulation with exogenous TSH revealed subnormal responses of the serum T4I, RAIU, or both, in 7 of 11 patients tested. An abnormal iodideperchlorate discharge test was found in 5 of 10 patients and appeared most abnormal in patients with abnormal RAIU responses to TSH. Fluorescent antimicrosomal antibody was found in the serum of 12 of the 15 patients, in contrast to an expected frequency of 7% in normal individuals of the same age.

Authors

Lawrence C. Wood, Sidney H. Ingbar