title: Disappearance of humoral thyroid autoimmunity after complete removal of thyroid antigens.
abstract: BACKGROUND
  The development of antibodies to thyroid peroxidase, thyroglobulin, and thyroid-stimulating hormone (TSH) receptor is a main feature of autoimmune thyroid diseases.
  
  
  OBJECTIVE
  To investigate whether complete removal of thyroid antigens results in the abatement of humoral thyroid autoimmunity.
  
  
  METHODS
  Retrospective chart review study of patients treated and monitored with a standard prospective protocol.
  
  
  METHODS
  University hospital in Pisa, Italy, between 1976 and 1994.
  
  
  METHODS
  182 patients with differentiated thyroid carcinoma and serum antibodies to thyroid peroxidase, thyroglobulin, or TSH receptor due to coexistent clinical Hashimoto thyroiditis, Graves disease, or focal autoimmune thyroiditis.
  
  
  METHODS
  Total thyroidectomy and radioiodine treatment to ablate residual or metastatic thyroid tissue. Regular follow-up with iodine-131 whole-body scanning and serum thyroglobulin measurement. Mean follow-up (+/-SD) was 10.1 +/- 4.1 years (range, 4 to 20 years).
  
  
  METHODS
  Serum antibodies to thyroid peroxidase, thyroglobulin, and TSH receptor.
  
  
  RESULTS
  Thyroid peroxidase, thyroglobulin, and TSH-receptor antibodies progressively disappeared after the initial treatment. The median disappearance time was 6.3 years for thyroid peroxidase antibodies and 3.0 years for thyroglobulin antibodies. There was a statistically significant correlation between the disappearance of thyroid tissue and that of thyroid antibodies. The coexistence of Hashimoto thyroiditis or Graves disease with thyroid cancer did not modify the pattern of disappearance of thyroid antibody compared with patients with focal autoimmune thyroiditis.
  
  
  CONCLUSIONS
  Complete ablation of thyroid tissue with its antigenic components results in the disappearance of antibodies to all major thyroid antigens, thus supporting the concept that continued antibody production depends on the persistence of autoantigen in the body.
authors.affiliation: Università di Pisa, Pisa, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Chiovato
authors.forename: Francesco
authors.initials: F
authors.lastname: Latrofa
authors.forename: Lewis E
authors.initials: LE
authors.lastname: Braverman
authors.forename: Furio
authors.initials: F
authors.lastname: Pacini
authors.forename: Marco
authors.initials: M
authors.lastname: Capezzone
authors.forename: Lucio
authors.initials: L
authors.lastname: Masserini
authors.forename: Lucia
authors.initials: L
authors.lastname: Grasso
authors.forename: Aldo
authors.initials: A
authors.lastname: Pinchera
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001323:Autoantibodies / Q000097:blood*; D015551:Autoimmunity; D002648:Child; D005260:Female; D006801:Humans; D007453:Iodide Peroxidase / Q000276:immunology; D007457:Iodine Radioisotopes / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011989:Receptors, Thyrotropin / Q000276:immunology; D012189:Retrospective Studies; D013954:Thyroglobulin / Q000276:immunology; D013959:Thyroid Diseases / Q000150:complications / Q000276:immunology*; D013961:Thyroid Gland / Q000276:immunology*; D013964:Thyroid Neoplasms / Q000150:complications / Q000276:immunology / Q000628:therapy; D013965:Thyroidectomy
chemical_list: D001323:Autoantibodies; D007457:Iodine Radioisotopes; D011989:Receptors, Thyrotropin; D013954:Thyroglobulin; D007453:Iodide Peroxidase