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

Global Journal of Health Science Pub Date : 2022-11-22 DOI:10.5539/gjhs.v14n12p28

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.

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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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Global Journal of Health Science

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