Fluctuating Hyperthyroidism and Hypothyroidism in Graves’ Disease: The Swinging Between Two Clinical Entities

Shrestha, Aakriti; Adhikari, Namrata; Devkota, Saujan; Chowdhury, Tutul; Shiferaw-Deribe, Zewge; Gousy, Nicole; Adhikari, Samaj

doi:10.7759/cureus.27715

Cited by 2 publications

(3 citation statements)

References 8 publications

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“…From the functional and biological points of view, TRAbs can be classified in three ways, stimulators, blockers, and neutral; for GBD, the most frequent are the stimulators. Stimulator TRAbs bind to the N-terminus of the TSH extracellular domain and consequently stimulate TH production (independently of the feedback phenomenon of the hypothalamic–pituitary–thyroid axis) [ 74 , 75 ].…”

Section: Major Thyroid Absmentioning

confidence: 99%

The Usefulness of Thyroid Antibodies in the Diagnostic Approach to Autoimmune Thyroid Disease

et al. 2023

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Autoimmune thyroid disease (AITD) refers to a spectrum of various diseases, with two extremes of clinical presentation, hypothyroidism (Hashimoto’s thyroiditis (HT) and hyperthyroidism (Graves–Basedow disease (GBD)). Both conditions are characterized by presenting a cellular and humoral autoimmune reaction, with an increase in the synthesis and secretion of antibodies directed toward various thyroid antigens, together with a phenomenon of thyrocyte necrosis and apoptosis (in HT) and a persistent thyrotropin-receptor stimulation (in GBD). The diagnosis of both entities is based on clinical, laboratory, and imaging findings. Three major anti-thyroid antibodies have been described, those directed against the TSH receptor (TRAb), against thyroid peroxidase (TPOAb), and against thyroglobulin (TgAb). Each of these autoantibodies plays a fundamental role in the diagnostic approach of autoimmune thyroid disease. TRAbs are the hallmark of GBD, and additionally, they are predictors of response to disease treatment, among other utilities. Likewise, TPOAb and TgAb allow for identifying individuals with a higher risk of progression to hypothyroidism; the positivity of one or both autoantibodies defines the presence of thyroid autoimmunity. In this review, the usefulness of anti-thyroid antibodies in the diagnostic approach to autoimmune thyroid disease is described.

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Section: Major Thyroid Absmentioning

confidence: 99%

The Usefulness of Thyroid Antibodies in the Diagnostic Approach to Autoimmune Thyroid Disease

et al. 2023

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“…HT is characterized by the presence of specific autoantibodies, such as thyroid peroxidase (TPOAb) and thyroglobulin (TgAb) antibodies. Both HT and Graves' Disease are classified as autoimmune thyroid disorders (AITDs), sometimes called "the opposite poles of the same disease" [3,4]. Their natural history is modified by various influencing factors, e.g., infection, genetic and environmental reasons.…”

Section: Introductionmentioning

confidence: 99%

“…The coexistence of AITD with different autoimmune disorders is another commonly observed dependence [15] (Figure 1). classified as autoimmune thyroid disorders (AITDs), sometimes called "the opposite of the same disease" [3,4]. Their natural history is modified by various influencing fa e.g., infection, genetic and environmental reasons.…”

Section: Introductionmentioning

confidence: 99%

Autoimmunity, New Potential Biomarkers and the Thyroid Gland—The Perspective of Hashimoto’s Thyroiditis and Its Treatment

Tywanek,

Michalak,

Świrska

et al. 2024

IJMS

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Autoimmune thyroid disease (AITD) is the most common organic specific illness of the thyroid gland. It may manifest as the overproduction or the decline of thyroxine and triiodothyronine. Hyperthyroidism develops due to the overproduction of hormones as an answer to the presence of stimulatory antibodies against the TSH receptor. Hashimoto’s thyroiditis (HT) is generally characterized by the presence of thyroid peroxidase and thyroglobulin antibodies, with a concomitant infiltration of lymphocytes in the thyroid. Due to the progressive destruction of cells, AITD can lead to subclinical or overt hypothyroidism. Pathophysiology of AITD is extremely complicated and still not fully understood, with genetic, environmental and epigenetic factors involved in its development. Due to increasing incidence and social awareness of this pathology, there is an urgent need to expand the background concerning AITD. A growing body of evidence suggests possible ways of treatment apart from traditional approaches. Simultaneously, the role of potential new biomarkers in the diagnosis and monitoring of AITD has been highlighted recently, too. Therefore, we decided to review therapeutic trends in the course of AITD based on its pathophysiological mechanisms, mainly focusing on HT. Another aim was to summarize the state of knowledge regarding the role of new biomarkers in this condition.

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Fluctuating Hyperthyroidism and Hypothyroidism in Graves’ Disease: The Swinging Between Two Clinical Entities

Cited by 2 publications

References 8 publications

The Usefulness of Thyroid Antibodies in the Diagnostic Approach to Autoimmune Thyroid Disease

The Usefulness of Thyroid Antibodies in the Diagnostic Approach to Autoimmune Thyroid Disease

Autoimmunity, New Potential Biomarkers and the Thyroid Gland—The Perspective of Hashimoto’s Thyroiditis and Its Treatment

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