Predictors of relapse rate in adults with autoimmune disease with autoimmune thyroiditis

Paula Torres; M. Martinez; D. Castro

doi:10.5281/zenodo.22812494

Authors

Paula Torres Division of Allergy and Immunotherapy, Yamuna Institute for Advanced Allergy and Immunotherapy Author https://orcid.org/4184-0288-7665-107X
M. Martinez Department of Clinical Immunology, Vistula Research Center for Clinical Immunology Author https://orcid.org/6893-7682-5038-7721
D. Castro Department of Clinical Allergy and Immunotherapy, Ebro Institute of Allergy and Immunotherapy Author https://orcid.org/1748-9230-1802-565X

DOI:

https://doi.org/10.5281/zenodo.22812494

Keywords:

autoimmune thyroiditis, relapse, polyautoimmunity, thyroid autoantibodies, postpartum thyroiditis

Abstract

Background: Autoimmune thyroiditis frequently clusters with other autoimmune diseases, and this polyautoimmunity may alter the risk of relapse after apparent remission or after treatment withdrawal.

Objective: This review synthesizes published evidence on predictors of relapse in adults with autoimmune thyroiditis, with particular attention to comorbid autoimmune disease, antibody trajectory, and modifiable risk factors.

Methods: We conducted a narrative synthesis of prospective cohort studies, randomized trials, population surveys, and systematic reviews addressing thyroid autoantibody status, TSH-receptor antibody status, polyautoimmunity, postpartum thyroiditis, and modifiable factors in adults with autoimmune thyroiditis.

Findings: Rising or persistent thyroid antibody titer predicts progression and relapse across phenotypes; TSH-receptor antibody positivity at antithyroid drug withdrawal predicts Graves' relapse; comorbid type 1 diabetes roughly doubles to triples postpartum thyroid dysfunction risk; and selenium supplementation lowers antibody titer without a proven effect on hard relapse endpoints.

Conclusions: Antibody status and trajectory remain the most reproducible relapse predictors in autoimmune thyroiditis, and their predictive value is sharpened by accounting for comorbid autoimmune disease, supporting closer, comorbidity-aware surveillance around antithyroid drug withdrawal and the postpartum period.

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Predictors of relapse rate in adults with autoimmune disease with autoimmune thyroiditis

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