The natural history of autoimmune thyroid disease

The autoimmune thyroid diseases have several clinical forms and undergo considerable variation in time in clinical, functional, and serological expression. These variations may best be understood in the light of a number of variables which interact in determining the nature of the disorder in each individual. These variable include subtle differences in genetics between one disorder and another, the magnitude of the organ-specific immunoregulatory defect and the superimposed influence of environmental factors (including hormonal factors) on the overall immune system. The latter influence may be of major importance in bringing about the remarkable variations observed over time in many patients in the expression of their conditions.