Hashimoto's Thyroiditis high Symptom Load

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Thyroid.

2010 Dec 27. [Epub ahead of print]

Hashimoto's Thyroiditis Affects Symptom Load and Quality of

Life Unrelated to Hypothyroidism: A Prospective Case-Control Study in Women

Undergoing Thyroidectomy for Benign Goiter.

Ott J,

Promberger

R, Kober

F, Neuhold

N, Tea M,

Huber

JC, Hermann

M.

1 Department of

Surgery, Kaiserin beth Spital , Vienna, Austria .

Abstract

Background: Hashimoto's thyroiditis (HT) is a common disease, and is the

most prevalent cause of hypothyroidism. Symptoms and diseases associated with HT

are considered to be caused by hypothyroidism. We hypothesized that higher

antithyroperoxidase (anti-TPO) antibody levels would be associated with an

increased symptom load and a decreased quality of life in a female euthyroid

patient collective. Methods: In a prospective cohort study 426 consecutive

euthyroid female patients undergoing thyroid surgery for benign thyroid disease

were included. Main outcome measures were preoperative anti-TPO levels, a

symptom questionnaire and the SF-36 questionnaire, and lymphocytic infiltration

of the thyroid tissue as evaluated by histology. Results: Histology revealed HT

in 28/426 (6.6%) subjects. To maximize the sum of the predictive values, a

cut-off point for anti-TPO of 121.0 IU/mL

was calculated (sensitivity 93.3% [95% confidence interval: 77.9%-99.0%];

specificity 94.7% [95% confidence interval: 92.0%-96.7%]) to predict the

presence of histological signs of HT. The mean number of reported symptoms was

significantly higher in patients with anti-TPO levels >121.0 IU/mL than in the other

group (6.7 ± 2.5 vs. 4.1 ± 2.8; p < 0.001). There were no

differences in preoperative thyroid-stimulating hormone levels (1.7 ± 1.3 vs. 1.5 ± 1.4 μU/mL, respectively; p = 0.155).

Chronic fatigue, dry hair, chronic irritability, chronic nervousness, a history

of breast cancer and early miscarriage, and lower quality-of-life levels were

significantly associated with anti-TPO levels exceeding the cut-off point (p < 0.05). Conclusions: Women with HT suffer from a

high symptom load. Hypothyroidism is only a contributing factor to the

development of associated conditions.

PMID: 21186954 [PubMed

- as supplied by publisher]