Changes of TSH-Stimulation Blocking Antibody (TSBAb) and Thyroid Stimulating Antibody (TSAb) Over 10 Years in 34 TSBAb-Positive Patients with Hypothyroidism and in 98 TSAb-Positive Graves’ Patients with Hyperthyroidism: Reevaluation of TSBAb and TSAb in TSH-Receptor-Antibody (TRAb)-Positive Patients

Table 3

Atrophic autoimmune thyroiditis or goitrous autoimmune thyroiditis in the 34 TSBAb (TSH-stimulation-blocking-antibody)- positive patients with hypothyroidism (a) and recovery from hypothyroidism (b).

(a) Atrophic autoimmune thyroiditis (atrophic) or goitrous autoimmune thyroiditis (goitrous) in the 34 TSBAb-positive patients with hypothyroidism

		34 TSBAb-positive patients with hypothyroidism (I in Table 1)^†		34
				Atrophic (24)	Goitrous (10)
a: Positive TSBAb persisted (Ia)			17	17	0
b: TSBAb disappeared (Ib)	15	b1: recovered (Ib1)	13	5	8
		b2: hypothyroid (Ib2)	2	2	0
c: TSBAb → TSAb (Ic)			2	0	2

Numbers of the patients are shown. (I in Table 1)^† correspond to those in Table 1
Among the 34 TSBAb-positive patients with hypothyroidism (Table 1, I), 24 had atrophic autoimmune thyroiditis and 10 had goitrous autoimmune thyroiditis. The 34 TSBAb-positive patients with hypothyroidism consisted of 17 patients (a: positive TSBAb persisited), 15 patients (b: TSBAb disappeared), and 2 patients (c: TSBAb → TSAb). All of the 17 (a) patients continued to have positive TSBAb and continued to have hypothyroidism. All of the 17 (a) patients had atrophic autoimmune thyroiditis and none of them had goitrous autoimmune thyroiditis. TSBAb disappeared in the 15 (b) patients: 13 (b1) (87%) of the 15 (b) patients recovered from hypothyroidism and 2 (b2) (13%) of the 15 (b) patients continued to have hypothyroidism. Of the 13 (b1) patients, who recovered from hypothyroidism, 5 had atrophic autoimmune thyroiditis and 8 had goitrous autoimmune thyroiditis. The 2 (b2) patients, who continued to have hypothyroidism, had atrophic autoimmune thyroiditis. Of the 15 (b) patients, in whom TSBAb had disappeared, 7 [5 (b1) + 2 (b2)] had atrophic autoimmune thyroiditis and 8 [8 (b1)] had goitrous autoimmune thyroiditis. Two (c) patients of the 34 TSBAb-positive patients with hypothyroidism who developed TSAb-positive Graves’ hyperthyroidism who had goitrous autoimmune thyroiditis.

(b) Recovery from hypothyroidism in the patients with atrophic autoimmune thyroiditis (atrophic) and in those with goitrous autoimmune thyroiditis (goitrous)

	Atrophic (24)	Goitrous (10)
Continued to have hypothyroidism	19 (79%); [17(a)+2(b2)]*	0 (0%)	19
Recovered from hypothyroidism	5 (21%); [5(b1)]*	10 (100%); [8(b1)+2(c)]^∗	15	𝜒^2=17.9   𝑃value<0.05
	24 (100%)	10 (100%)	34

Numbers (%) of the patients are shown. []*corresponds to Table 3(a).
Among the 34 TSBAb-positive patients with hypothyroidism (Table 1, I), 24 had atrophic autoimmune thyroiditis and 10 had goitrous autoimmune thyroiditis. Among the 34 TSBAb-positive patients with hypothyroidism, 19 [(17 (a) + 2 (b2)] (Table 3(a)) continued to have hypothyroidism over 10 years and 15 [13 (b1) + 2 (c)] recovered from hypothyroidism [13 (b1) recovered from hypothyroidism and had remissions and 2 (c) recovered from hypothyroidism and developed hyperthyroidism]. All of the 19 TSBAb-positive patients with hypothyroidism, who continued to have hypothyroidism [17 (a) + 2 (b2)], had atrophic autoimmune thyroiditis, and none of them had goitrous autoimmune thyroiditis. Fifteen [13 (b1) + 2 (c)] of the 34 TSBAb-positive patients with hypothyroidism recovered from hypothyroidism. Five [5 (b1)] of the 15 patients, who recovered from hypothyroidism, had atrophic autoimmune thyroiditis and the other 10 [8 (b1) + 2 (c)] had goitrous autoimmune thyroiditis. Nineteen (79%) of the 24 TSBAb-positive hypothyroid patients with atrophic autoimmune thyroiditis continued to have hypothyroidism and the other 5 (21%) of them recovered from hypothyroidism. All of the 10 TSBAb-positive hypothyroid patients with goitrous autoimmune thyroiditis [8 (b1) + 2 (c)] recovered from hypothyroidism. Significant differences of recovery from hypothyroidism were noted between the patients with goitrous autoimmune thyroiditis and those with atrophic autoimmune thyroiditis (𝜒²= 17.9, 𝑃value<0.05). All (100%) of the 10 TSBAb-positive patients with goitrous autoimmune thyroiditis recovered from hypothyroidism and 19 (79%) of the 24 patients with atrophic autoimmune thyroiditis continued to have hypothyroidism.