The incidence of occult thyroid disease associated with thyroid antibodies identified on routine autoantibody screening

Publisher Website
Google Scholar
Abstract
The presence of thyroid microsomal and/or thyroglobulin antibodies was recorded over a 2 yr period in 15,000 consecutive autoimmune profile requests. Where there had been no initial clinical suspicion of thyroid diseases, 332 requests showed positive thyroid antibodies, and of these 63 (19%) had abnormal in vitro thyroid function tests (TFT). No differences were observed between the abnormal and normal groups with respect to the presence of different autoantibodies or to the age and sex distributions. Of these subjects with clinically unsuspected hypothyroidism but with abnormal TFT, 29% were commenced on thyroxine therapy and experienced a symptomatic improvement, 25% remain well on no therapy and 9% continue on no treatment but with symptoms possibly attributable to hypothyroidism. Three percent became clinically hypothyroid during a follow-up period of 2 yr. Five percent died of unrelated causes and there was inadequate follow-up information on the remainder. When thyroid antibodies, and in particlar thyroid microsomal antibody, are found unexpectedly, a significant proportion of patients will have biochemical evidence of hypothyroidism and may benefit from appropriate treatment.