title: Autoimmune thyroid disease--a continuous spectrum.
abstract: OBJECTIVE
  to present a case report revealing a variant of natural history of autoimmune thyroid disease.
  
  
  METHODS
  I.F., a 39 years old woman, had a previous medical history of Graves' disease treated with antithyroid drugs (ATD). After 1 year of treatment, the remission was confirmed one and two years after ATD withdrawal. Twenty years after the initial hyperthyroidism, spontaneous subclinical hypothyroidism was diagnosed. The patient presented both anti TSH-receptor (TSH-R) antibodies (Ab), antithyroperoxidase (TPO) and antithyroglobulin (antiTgl) antibodies in elevated titres.
  
  
  CONCLUSIONS
  Because of the shift from hyperthyroidism to euthyroidism or to spontaneous hypothyroidism, Graves' disease patients demand a strict follow-up after ATD therapy. It seems that there is an effect of TPOAb on thyroid destruction.
authors.affiliation: Carol Davila University of Medicine and Pharmacy, Bucharest, Romania. ralucatrifanescu@yahoo.com
authors.forename: Raluca
authors.initials: R
authors.lastname: Trifănescu
authors.forename: Cătălina
authors.initials: C
authors.lastname: Poiană
authors.forename: D
authors.initials: D
authors.lastname: Hortopan
mesh_terms: D000328:Adult; D001323:Autoantibodies / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D005260:Female; D006111:Graves Disease / Q000628:therapy; D050031:Hashimoto Disease / Q000175:diagnosis* / Q000276:immunology*; D006801:Humans; D007453:Iodide Peroxidase / Q000276:immunology; D013967:Thyroiditis, Autoimmune / Q000175:diagnosis / Q000276:immunology; D013972:Thyrotropin / Q000276:immunology
chemical_list: D001323:Autoantibodies; D015415:Biomarkers; C006606:anti-thyroglobulin; D013972:Thyrotropin; D007453:Iodide Peroxidase