The Journal of clinical endocrinology and metabolism · 2026
Clinical Characteristics and Outcomes of Graves' Disease in Individuals with Prior Hypothyroidism.
СтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Nakhleh Afif, Robenshtok Eyal, Adler Limor, Shapiro Ben David Shirley, Rahamim-Cohen Daniella, Liran Ori, Zolotov Sagit
Аннотация
CONTEXT: Transition from hypothyroidism to Graves' disease (GD) is uncommon.
OBJECTIVE: To compare presentation, management, and outcomes of GD after hypothyroidism (post-hypo-GD) with GD controls (no prior thyroid disease).
DESIGN: Retrospective cohort 2010 to 2022, followed through October 2024.
SETTING: Maccabi Healthcare Services, Israeli health maintenance organization.
PATIENTS: Adults with incident GD and thyroid-stimulating immunoglobulin activity ≥140% within 1 year of thyrotoxicosis (N = 2402, 256 post-hypo-GD, 2146 GD controls). Excluded prior or current amiodarone users.
INTERVENTIONS: Longitudinal assessment of usual care with antithyroid drugs, radioactive iodine, or total thyroidectomy, and subsequent hypothyroidism requiring levothyroxine.
MAIN OUTCOME MEASURES: Usual care treatments and incident hypothyroidism requiring levothyroxine.
RESULTS: Compared to GD controls, post-hypo-GD patients were older (51.4 ± 14.3 vs 47.4 ± 13.6 years, P < .001), predominantly female (88.2% vs 76.9%, P < .001), and with higher prevalence of autoimmune disease (19.5% vs 12.9%, P = .003). At diagnosis, post-hypo-GD patients had milder disease with lower median free T4 (21.7 vs 26.8 pmol/L, P < .001) and free T3 (8.5 vs 10.4 pmol/L, P < .001) levels. Over a 7.2-year median follow-up, post-hypo-GD patients were less frequently treated with antithyroid drugs (65.6% vs 81.0%, P < .001). Radioactive iodine ablation and total thyroidectomy use were comparable. Post-hypo-GD patients were more than twice as likely to develop hypothyroidism requiring levothyroxine at the end of follow-up (41.8% vs 21.0%, P < .001).
CONCLUSION: Post-hypo-GD (∼10% of new GD cases) is a distinct, predominantly female phenotype marked by milder thyrotoxicosis, lower antithyroid drug use, and a high rate of relapse into hypothyroidism warranting routine assessment of prior thyroid status and close biochemical monitoring.
OBJECTIVE: To compare presentation, management, and outcomes of GD after hypothyroidism (post-hypo-GD) with GD controls (no prior thyroid disease).
DESIGN: Retrospective cohort 2010 to 2022, followed through October 2024.
SETTING: Maccabi Healthcare Services, Israeli health maintenance organization.
PATIENTS: Adults with incident GD and thyroid-stimulating immunoglobulin activity ≥140% within 1 year of thyrotoxicosis (N = 2402, 256 post-hypo-GD, 2146 GD controls). Excluded prior or current amiodarone users.
INTERVENTIONS: Longitudinal assessment of usual care with antithyroid drugs, radioactive iodine, or total thyroidectomy, and subsequent hypothyroidism requiring levothyroxine.
MAIN OUTCOME MEASURES: Usual care treatments and incident hypothyroidism requiring levothyroxine.
RESULTS: Compared to GD controls, post-hypo-GD patients were older (51.4 ± 14.3 vs 47.4 ± 13.6 years, P < .001), predominantly female (88.2% vs 76.9%, P < .001), and with higher prevalence of autoimmune disease (19.5% vs 12.9%, P = .003). At diagnosis, post-hypo-GD patients had milder disease with lower median free T4 (21.7 vs 26.8 pmol/L, P < .001) and free T3 (8.5 vs 10.4 pmol/L, P < .001) levels. Over a 7.2-year median follow-up, post-hypo-GD patients were less frequently treated with antithyroid drugs (65.6% vs 81.0%, P < .001). Radioactive iodine ablation and total thyroidectomy use were comparable. Post-hypo-GD patients were more than twice as likely to develop hypothyroidism requiring levothyroxine at the end of follow-up (41.8% vs 21.0%, P < .001).
CONCLUSION: Post-hypo-GD (∼10% of new GD cases) is a distinct, predominantly female phenotype marked by milder thyrotoxicosis, lower antithyroid drug use, and a high rate of relapse into hypothyroidism warranting routine assessment of prior thyroid status and close biochemical monitoring.