TSH receptor antibody‐associated thyroid dysfunction following subacute thyroiditis

Abstract

Subacute thyroiditis may trigger autoreactive B cells to produce TSH receptor antibodies, resulting in TSH receptor antibody-associated thyroid dysfunction in some patients.

Subacute Thyroiditis with Highly Positive Thyrotropin Receptor Antibodies and High Thyroidal Radioactive Iodine Uptake

“…In our case the serum TRAbhad presented and gradually decreased over about nine months, and there was no autonomousproduction of TRAb,which is the difference from Graves' disease's autonomic production of TRAb. Iitaka et al reviewed 1,697 patients with SAT for 10 years, but not all of the cases were examined histologically (12). In their report, there were only five patients of hyperthyroidism with serum positive TRAbon their first visit, and only one patient' TRAb became negative spontaneously eight months later, and the TRAbtiter increased afterwards in the rest four hyperthyroid patients.…”

“…Thirty-two patients showed high titers of TRAband TSAb during the acute thyrotoxic phase of SATand four of them had high thyroidal RAIUor 99mTc uptake (7)(8)(9)(10)(11)(12). Histological examination of the thyroid gland, however, was reported in only three patients (7,10).…”

Follow-up of a case of subacute thyroiditis with uncommon thyroid 99mTc uptake

“…Iitaka and cols. (8) found that patients who appeared positive for TRAb after SAT had genetic background predisposing to Graves' disease. This finding may explain why only 10% SAT may produce TRAb.…”

“…Arq Bras Endocrinol Metab. 2013;57 (8) Tc uptake increased slightly in the right-side painful thyroid gland, and decreased in left painless thyroid gland. This phenomenon is very rare and the underlying cause is not clear.…”

Graves' Disease Following Subacute Thyroiditis

“…However, we encountered 7 patients with Graves' disease following subacute thyroiditis. In the literature, 26 patients with Graves' disease following subacute thyroiditis have been reported (Sheets 1955;Perloff 1956;Werner 1979;Wartofsky and Shaaf 1987;Fukata et al 1992;Bartalena et al 1996;Bennedbeak et al 1996;Grunenberger et al 1998;Iitaka et al 1998Iitaka et al , 2001Wang and Renedo 2004). The diagnosis of Graves' disease in such patients is always difficult because of atypical signs and symptoms and an unclear onset time.…”