Academic Journal
Clinical and Ultrasonographic Characterization of the Transition from Hashimoto Thyroiditis to Graves' Disease: A Long-term Follow-up Study.
| Τίτλος: | Clinical and Ultrasonographic Characterization of the Transition from Hashimoto Thyroiditis to Graves' Disease: A Long-term Follow-up Study. |
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| Συγγραφείς: | Vassallo A; Institute of Endocrine and Metabolic Sciences, Università Vita-Salute San Raffaele and IRCCS Ospedale San Raffaele, Milan, Italy., Ferrari F; Institute of Endocrine and Metabolic Sciences, Università Vita-Salute San Raffaele and IRCCS Ospedale San Raffaele, Milan, Italy., di Filippo L; Institute of Endocrine and Metabolic Sciences, Università Vita-Salute San Raffaele and IRCCS Ospedale San Raffaele, Milan, Italy., Perticone F; Institute of Endocrine and Metabolic Sciences, Università Vita-Salute San Raffaele and IRCCS Ospedale San Raffaele, Milan, Italy., Castellino L; Institute of Endocrine and Metabolic Sciences, Università Vita-Salute San Raffaele and IRCCS Ospedale San Raffaele, Milan, Italy., Giustina A; Institute of Endocrine and Metabolic Sciences, Università Vita-Salute San Raffaele and IRCCS Ospedale San Raffaele, Milan, Italy., Loli P; Institute of Endocrine and Metabolic Sciences, Università Vita-Salute San Raffaele and IRCCS Ospedale San Raffaele, Milan, Italy. loli.paola@hsr.it. |
| Πηγή: | Endocrine [Endocrine] 2026 Mar 10; Vol. 91 (1). Date of Electronic Publication: 2026 Mar 10. |
| Τύπος έκδοσης: | Journal Article |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: Humana Press Country of Publication: United States NLM ID: 9434444 Publication Model: Electronic Cited Medium: Internet ISSN: 1559-0100 (Electronic) Linking ISSN: 1355008X NLM ISO Abbreviation: Endocrine Subsets: MEDLINE |
| Imprint Name(s): | Publication: Feb. 1996- : Totowa, NJ : Humana Press Original Publication: Houndsmills, Basingstoke, Hants, UK : Macmillan Press, c1994- |
| Ιατρικοί όροι (MeSH): | Graves Disease*/diagnostic imaging , Graves Disease*/blood , Graves Disease*/pathology , Graves Disease*/drug therapy , Hashimoto Disease*/diagnostic imaging , Hashimoto Disease*/blood , Hashimoto Disease*/drug therapy , Thyroid Gland*/diagnostic imaging, Thyrotropin/blood ; Humans ; Female ; Ultrasonography ; Adult ; Follow-Up Studies ; Male ; Middle Aged ; Disease Progression |
| Περίληψη: | PURPOSE: Conversion of Hashimoto Thyroiditis (HT) to Graves’ disease (GD) is uncommon. Patients experiencing this immunological transition have a milder form of hyperthyroidism. Nevertheless, US features, clinical course and outcome of thyroid function during long term follow up of these patients have not been systemically characterized so far. METHODS: 41 patients with conversion from HT to GD were compared with 214 patients with GD. Demographic, clinical and hormonal data as well as thyroid ultrasound (US) features, remission and relapse rates were evaluated. RESULTS: TSH concentrations were significantly lower and fT4 and fT3 higher in GD compared to the switchers, despite lower TRAb levels. A higher number of switchers achieved remission with a first ATD course compared to GD patients. The number of patients achieving final remission with medical therapy was significantly higher in the switchers and remission was achieved in lower mean time and with lower mean dose of ATD; conversely, a higher number of GD patients required definitive ablative therapy. The switchers had a significantly higher prevalence of spontaneous early hypothyroidism following ATD treatment. Thyroid US evaluation showed significantly higher prevalence of thyroid hypotrophy and reduced parenchymal vascularization and a significantly lower prevalence of multinodular thyroid glands in the switchers compared to GD patients. CONCLUSIONS: Autoimmune thyroiditis shifting from Hashimoto to Graves’ disease is characterized by a distinct clinical-ultrasonographic phenotype and clinical course of hyperthyroidism. Strict monitoring of thyroid function is required in these patients as both hyperthyroidism recurrence and early spontaneous return to hypothyroidism are common. |
| Competing Interests: | Declarations. Ethical approval: All adult patients (age ≥ 18 years) affected by autoimmune thyroid disorders were included in an epidemiologic monocentric register approved by the Local Ethics Committee complying with the Declaration of Helsinki. Informed consent: A signed informed consent was obtained for all patients participating in the study. Conflict of interests: The authors declare no competing interests. |
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| Contributed Indexing: | Keywords: Graves’ disease; Hashimoto thyroiditis; TBAb; TRAB; TSAb; Transition |
| Substance Nomenclature: | 9002-71-5 (Thyrotropin) |
| Entry Date(s): | Date Created: 20260310 Date Completed: 20260627 Latest Revision: 20261009 |
| Update Code: | 20261009 |
| DOI: | 10.1007/s12020-026-04582-y |
| PMID: | 41803404 |
| Βάση Δεδομένων: | MEDLINE |
| ISSN: | 1559-0100 |
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| DOI: | 10.1007/s12020-026-04582-y |