[Diffuse toxic goiter associated with autoimmune thyroiditis]

A study of 190 patients with diffuse toxic goiter combined with autoimmune thyroiditis has revealed some clinical features: a torpid course and a solid-elastic consistency of the thyroid. In 37.4% of the cases autoimmune thyroiditis was combined with a severe form of thyrotoxicosis. The combined form of diffuse toxic goiter correlated with a greater frequency of the detection of thyroid autoantibodies to thyroglobulin and microsomal antigen (in 83 and 78.3% of the patients respectively) as compared to the common form of diffuse toxic goiter (in 47.3 and 48.1%). A study of the hormonal thyroid status of 43 patients with diffuse toxic goiter combined with autoimmune thyroiditis showed that T3, T4 and TTH levels in patients with the presence of autoantibodies to thyroid antigens did not differ from the levels of these hormones in the common form of diffuse toxic goiter, and in the group of the patients with the absence of autoantibodies there was a tendency to the development of T3-toxicosis. The absence of pathognomic symptoms in combined forms of diffuse toxic goiter makes their preoperative diagnosis difficult. Interrelationship of the hormonal thyroid status and humoral antithyroid immunity was noted.