Assessment of Clinical and Laboratory Limits between Hashitoxicosis and Graves’ Disease

Juliana Delfino dos Reis, T. C. M. Feibelmann, B. P. Ferreira, M. A. Lima, Janaíne Machado Tomé, Flávia Alves Ribeiro, Beatriz Hallal Jorge Lara, M. Borges
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Abstract

BACKGROUND: Determine the clinical and laboratory features of Hashitoxicosis (Htx) and set standards that will help perform a differential diagnosis with Graves’Disease (GD). SUBJECTS & METHODS: we evaluated 45 patients with Htx (Hashi-group) diagnosed between January/1995 and July/2019 with autoimmune hyperthyroidism and cytology compatible with Hashimoto’s Thyroiditis (HT). The control group consisted of 51 patients with GD (Graves-group). RESULTS: clinical hyperthyroidism, free T4 (FT4), thyroid volume and need for antithyroid drugs were higher in the Graves-Group. Values of anti-thyroid antibodies and TSH were higher in the Hashi-Group. The definitive diagnostic criterion was cytology. Regarding the clinical course, 95% of the Hashi-Group had hyperthyroidism of short duration, while 84.3% of Graves-Group required radioactive iodine (RAI). CONCLUSION: hyperthyroidism due to HT was milder than that associated with GD. In most citology was able to distinguish HT from GD and predict spontaneous resolution preventing unnecessary RAI.
烟毒中毒与格雷夫斯病的临床和实验室界限评估
背景:确定Hashitoxicosis (Htx)的临床和实验室特征,并制定有助于Graves病(GD)鉴别诊断的标准。研究对象和方法:我们评估了1995年1月至2019年7月诊断为自身免疫性甲状腺功能亢进和细胞学与桥本甲状腺炎(HT)相容的45例Htx(桥本组)患者。对照组为GD患者51例(graves组)。结果:graves组临床甲状腺功能亢进、游离T4 (FT4)、甲状腺体积及抗甲状腺药物需要量均较高。抗甲状腺抗体和TSH值在hashi组较高。最终的诊断标准是细胞学。在临床病程方面,95%的hashi组有短期甲状腺功能亢进,而84.3%的graves组需要放射性碘(RAI)。结论:HT所致甲亢较GD所致甲亢轻。在大多数情况下,citology能够区分HT和GD,并预测自发消退,防止不必要的RAI。
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