In Graves’ disease, thyroid autoantibodies and ultrasound features correlate with distinctive histological features

• Published in: Journal of endocrinological investigation Vol. 46; no. 8; pp. 1695 - 1703
• Main Authors: Brancatella, A., Torregrossa, L., Viola, N., Sgrò, D., Casula, M., Basolo, F., Materazzi, G., Marinò, M., Marcocci, C., Santini, F., Latrofa, F.
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01-08-2023; Springer Nature B.V
• Subjects: Autoantibodies; Endocrinology; Graves disease; Graves Disease - diagnostic imaging; Humans; Hyperplasia; Hyperthyroidism; Internal Medicine; Iodide peroxidase; Laboratories; Medicine; Medicine & Public Health; Metabolic Diseases; Original; Original Article; Receptors, Thyrotropin; Thyroglobulin; Thyroid; Thyroid gland; Thyroid-stimulating hormone; Thyroidectomy; Ultrasonic imaging; Ultrasound; Thyroperoxidase antibodies; Pathology; TSH receptor antibodies; Thyroglobulin antibodies; Graves’ disease; Hyperthyroidism
• ISSN: 1720-8386; 0391-4097; 1720-8386
• DOI: 10.1007/s40618-023-02044-0

Purpose
Laboratory, imaging, and pathological features of Graves’ disease (GD), although well characterized, have been barely correlated each other. Aim of the study was to link laboratory and ultrasound characteristics of GD with its pathological features.
Methods
We correlated laboratory and ultrasound data at the time of diagnosis in 28 consecutive GD patients who underwent thyroidectomy with their pathological features, i.e., lymphocytic infiltration and follicular hyperplasia (both classified as mild or severe).
Results
Thyroid volume correlated positively with the levels of FT4 (
P
 = 0.002,
r
2
 = 0.42), FT3 (
P
 = 0.011,
r
2
 = 0.22), autoantibodies to thyroglobulin (TgAbs) (
P
 = 0.016,
r
2
 = 0.32), autoantibodies to thyroid peroxidase (TPOAbs) (
P
 = 0.011,
r
2
 = 0.34) and the extent of lymphocytic infiltration (
P
 = 0.006 comparing mild to severe lymphocytic infiltration) but not with the levels of autoantibodies to the thyrotropin receptor (TRAbs) and to follicular hyperplasia. Compared to subjects with mild lymphocytic infiltration, those with severe lymphocytic infiltration showed higher levels of TgAbs (316 vs 0.0 IU/mL,
P
 < 0.0001) and TPOAbs (295 IU/mL vs 14 IU/mL,
P
 < 0.0001) and similar levels of TRAbs (7.5 vs 13 IU/mL,
P
 = 0.68). Compared to patients with mild, those with severe follicular hyperplasia had similar levels of TgAbs (76 vs 30 IU/mL,
P
 = 0.31) and TPOAbs (251 IU/mL vs 45 IU/mL,
P
 = 0.26) but higher levels of TRAbs (39 vs 7.2 IU/mL,
P
 < 0.001).
Conclusion
In GD, TgAbs and TPOAbs levels correlate with the extent of lymphocytic infiltration, TRAbs levels with the degree of follicular hyperplasia. Thyroid volume, the main factor influencing the severity of hyperthyroidism, is related to lymphocytic infiltration and not to follicular hyperplasia.