Serum thyroglobulin and its autoantibody following subtotal thyroid resection of Graves' disease

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Abstract
Thyroid surgery leads to marked changes of the levels of serum thyroglobulin and its autoantibodies in the subsequent 3 postoperative weeks. In Graves'' disease progression of exophthalmos has sometimes been seen following thyroidectomy. Nineteen medically pretreated patients with Graves'' disease and no signs of exophthalmos were studied systematically up to 6 mo. postoperatively. Nine patients had thyroglobulin antibodies. Mean values rose to 3.5 times pretreatment values within 2 mo. (P < 0.001) followed by a gradual fall below pretreatment level after 6 mo. None of the antibody-negative patients reverted to positive or vice versa. Serum thyroglobulin (n = 10) was elevated preoperatively (mean 309 .mu.g/l, SD 251), their values being normalized within 1-2 mo. (mean 19.4 .mu.g/l, SD 7.3). The preoperative serum thyroglobulin correlated to the weight of the removed thyroid tissue (r = 0.87, P < 0.01). Three patients showed elevated TSH after 1 mo. Of these, 2 developed myxedema, the 3rd remained euthyroid with persistently elevated serum thyroglobulin. None showed recurrence or developed exophthalmos within the period of observation. In spite of rising levels of thyroglobulin antibodies in all patients with antibodies none developed exophthalmos and only 1 patient with thyroglobulin antibodies had clinical myxedema.