Dataset Information

Thyroidectomy for Euthyroid Patients with Hashimoto Disease and Persistent Symptoms: An Observational, Postrandomization Study.

ABSTRACT:

Background

Despite adequate hormone substitution in Hashimoto disease, some patients may have persistent symptoms with a possible autoimmune pathophysiology. A recent randomized trial (RCT) using patient-reported outcome measures as the primary endpoint showed benefit in total thyroidectomy, but at a cost of high complication rates.

Objective

To verify results from the RCT in an observational study including a wider range of patients and explore means of predicting who may benefit from such surgery.

Design

A total of 154 patients with Hashimoto disease, euthyroid with or without thyroid hormone substitution, and persistent Hashimoto-related symptoms were subjected to total thyroidectomy and followed for 18 months after surgery. The primary outcome was the General Health (GH) dimensional score in the Short Form-36 Health Survey (SF-36).

Results

Eighteen months after surgery, a clinically significant improvement in GH was seen, similar to the findings in the previous RCT. Anti-TPO antibody titers were markedly reduced after surgery, but preoperative titers or other preoperative parameters could not predict the outcome of surgery. Three (1.9%) of 154 patients experienced permanent unilateral recurrent nerve palsy and six (3.9%) experienced hypoparathyroidism after surgery.

Conclusions

Thyroidectomy had a beneficial symptom-reducing effect in euthyroid patients with Hashimoto disease and persistent symptoms. The pathophysiology of residual symptoms remains unclear, and surgical complication rates are high. If thyroidectomy is considered as a treatment option, it should be performed in dedicated centers with experienced endocrine surgeons and as part of further studies on persistent symptoms. This trial is registered with NCT-02319538.

SUBMITTER: Hoff G

PROVIDER: S-EPMC11008973 | biostudies-literature | 2024

REPOSITORIES: biostudies-literature

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Publications

Thyroidectomy for Euthyroid Patients with Hashimoto Disease and Persistent Symptoms: An Observational, Postrandomization Study.

Hoff Geir G Bernklev Tomm T Johnsen Lene L Reitsma Laurens L Sina Dirk D Lauzike Andromeda A Gibbs Charlotte C Hoel Lende Tone T Narvestad Jon Kristian JK Kildahl Rasmus R Omdal Roald R Kvaløy Jan Terje JT Søiland Håvard H

Journal of thyroid research 20240404

<h4>Background</h4>Despite adequate hormone substitution in Hashimoto disease, some patients may have persistent symptoms with a possible autoimmune pathophysiology. A recent randomized trial (RCT) using patient-reported outcome measures as the primary endpoint showed benefit in total thyroidectomy, but at a cost of high complication rates.<h4>Objective</h4>To verify results from the RCT in an observational study including a wider range of patients and explore means of predicting who may benefit ...[more]

PMID: 38606313

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Dataset Information

Thyroidectomy for Euthyroid Patients with Hashimoto Disease and Persistent Symptoms: An Observational, Postrandomization Study.

Background

Objective

Design

Results

Conclusions

Publications

Thyroidectomy for Euthyroid Patients with Hashimoto Disease and Persistent Symptoms: An Observational, Postrandomization Study.

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