HASHIMOTO-TOXICOSIS - DIAGNOSTIC-CRITERIA AND EVOLUTION AFTER A 10-YEAR FOLLOW-UP

An study was carried out of the association of Basedow disease (B) and Hashimoto toxicosis (H), the response to the usual therapeutic regime ns and prognostic factors for the clinical course. Seventy-one patient s with the diagnosis of autoinmune hyperthyroidism were included. Sixt y-one of them were prospectively followed for 8.4 +/- 2.2 years (range : 5-10 years). All patients were treated following the same criteria w ith antithyroid drugs and aggressive therapy (radioiodine or surgery). Two groups were differentiated: group H (62%), with titers of antimic rosomal antibodies (AMSA) greater than or equal to 1/6,400 and a posit ive perchlorate discharge test (PDT), and group B, with AMSA titers < 1/6,400 and negative PDT. During follow-up a three-fold number of rela pses was observed in group H compared with group B, a higher frequency towards spontaneous hypothyroidism in the evolution (23% in H versus 0% in B), and higher requirements of radioiodine in H than in B. In ou r experience, H makes up and important percentage of autoimmune hypert hyroidism (62%) with a clinical course characterized by a higher numbe r of relapses, higher requirements of radioiodine and a higher rate to wards spontaneous hypothyroidism.