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Hashimoto disease is a chronic autoimmune thyroiditis.
that despite adequate hormone replacement, some patients still have persistent symptoms, which may be the result of immunophysiology.
this study was designed to determine whether patients with Hashimoto's thyroiditis, while receiving medical treatment, received thyroid excision in patients with normal thyroid function.
, designed in a randomized trial, was conducted at a secondary health hospital in Norway and included 150 patients between the ages of 18 and 79 who, despite normal thyroid function, still had ongoing hassle-related symptoms while receiving hormone replacement therapy and serum anti-thyroid peroxide (anti-TPO) antibody titration greater than 1000 IU/mL.
both groups had a full thyroid excision or hormone replacement therapy to ensure normal thyroid function.
result of the study was an overall health score for the 18-month Short Table 36 Health Survey (SF-36).
secondary results were adverse reactions to surgery, seven other SF-36s, fatigue questionnaire scores, and serum anti-TPO antibody titrations for 6, 12 and 18 months.
results showed that only the surgical group showed improvement during the follow-up period: the average overall health score increased from 38 to 64, with an 18-month difference of 29 points (95% CI, 22-35).
fatigue score dropped from 23 to 14, with an intergroup difference of 9.3 (CI, 7.4-11.2).
the frequency of chronic fatigue fell from 82% to 35%, with a 39 percentage point difference between groups (CI, 23-53 percentage points).
the mid-range serum anti-TPO antibody titration dropped from 2232 to 152 IU/mL, with an intergroup difference of 1148 IU/mL (CI, 1080 to 1304 IU/mL).
in multivariable regression analysis, the corrected therapeutic effect is still similar to the unalted effect.
, the results show that a full thyroidectomy improves health-related quality of life and fatigue, while medication does not.
, along with the elimination of serum anti-TPO antibodies, may shed light on the mechanism of the disease.
limitation of the study was that the results applied only to a subgroup of Patients with Hashimoto's disease, with a follow-up time limited to 18 months.
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