Immunological effects of Graves' disease therapy

Graves' disease is caused by thyroid stimulating antibodies and is accompanied by other autoimmune phenomena predisposing ultimately towards hypothyroidism. Antithyroid drugs directly alter the natural history of the condition, causing a remission in 50% of cases; part of this is likely to be due to their immunomodulatory effect. Surgery and radioiodine treatment are also accompanied by immunological changes which may affect outcome. In particular, some cases of hypothyroidism may be the result of a hastening of the natural progression to destructive thyroiditis.