title: Significance of prediagnostic thyroid antibodies in women with autoimmune thyroid disease.
abstract: BACKGROUND
  Antibodies to thyroglobulin (Tg), thyroperoxidase (TPO), and TSH receptor (TSH-R) are prevalent in autoimmune thyroid diseases. We aimed to assess whether females with Graves disease or Hashimoto thyroiditis are more likely than age-matched controls to have thyroid antibodies before clinical diagnosis and to measure the timing of antibody seroconversion.
  
  
  METHODS
  This was a nested case-control study using the Department of Defense Serum Repository and the Defense Medical Surveillance System, 1998-2007. We assessed thyroid antibodies in the serum of 522 female, active-duty, military personnel including: 87 Graves disease cases, 87 Hashimoto thyroiditis cases, and 348 age matched controls. One serum sample was available at the time of the clinical diagnosis (±6 months); three additional samples were retrieved from the repository up to 7 yr before the clinical diagnosis, for a total of 2088 samples.
  
  
  RESULTS
  In Hashimoto thyroiditis, TPO antibodies were found in about 66% of the cases at all time points. Tg antibodies showed a similar stationary trend, at a lower prevalence of about 53%at all time points. No TSH-R antibodies were found. In Graves disease, TPO antibodies gradually increased from 31% at 5-7 yr prior to diagnosis to 57% at diagnosis and Tg antibodies from 18 to 47%. TSH-R antibodies were present before diagnosis and showed an increasing prevalence from 2, 7, 20, to 55%.
  
  
  CONCLUSIONS
  Antibodies to Tg, TPO, and TSH-R precede by years the development of the diagnostic autoimmune thyroid diseases phenotype. Overall, the presence of thyroid antibodies in apparently healthy individuals should not be neglected.
authors.affiliation: Division of Gastroenterology and Hepatology, Johns Hopkins University, Baltimore, Maryland 21287, USA. shutfle1@jhmi.edu
authors.forename: Susan
authors.initials: S
authors.lastname: Hutfless
authors.forename: Peter
authors.initials: P
authors.lastname: Matos
authors.forename: Monica V
authors.initials: MV
authors.lastname: Talor
authors.forename: Patrizio
authors.initials: P
authors.lastname: Caturegli
authors.forename: Noel R
authors.initials: NR
authors.lastname: Rose
mesh_terms: D001323:Autoantibodies / Q000097:blood* / Q000276:immunology; D001324:Autoantigens / Q000276:immunology*; D016022:Case-Control Studies; D005260:Female; D006111:Graves Disease / Q000097:blood / Q000175:diagnosis* / Q000276:immunology; D050031:Hashimoto Disease / Q000097:blood / Q000175:diagnosis* / Q000276:immunology; D006801:Humans; D007453:Iodide Peroxidase / Q000276:immunology*; D033862:Iron-Binding Proteins / Q000276:immunology*; D011989:Receptors, Thyrotropin / Q000276:immunology*; D013954:Thyroglobulin / Q000276:immunology*
chemical_list: D001323:Autoantibodies; D001324:Autoantigens; D033862:Iron-Binding Proteins; D011989:Receptors, Thyrotropin; D013954:Thyroglobulin; C056658:TPO protein, human; D007453:Iodide Peroxidase