The Clinical Study On The Effects Of Glucocorticoid In Treatment Of Hashimoto Thyroiditis

Background:Hashimoto thyroiditis is one of commonest organ specific autoimmune thyroid diseases, which occur specific thyroid autoantibodies. Some research suggests that glucocorticoid has effect on selective cellular immunodepression.Objective:To evaluate the effects of oral prednisone on the high titre of thyroid peroxidase and antithyroglubulin antibodies in euthyroid or subclinical hypothyroidism subjects for clinical evidences on treatment of HT.Methods:In a 9-month study,56 subjects with high titre of thyroid peroxidase and antithyroglubulin antibodies in euthyroid or subclinical hypothyroidism were randomly divided into 2 groups. Subjects in prednisone group (28 cases) were treated with oral prednisone acetate tablets (10 mg, three times a day for 4 weeks and then reduce progressively 5 mg every 2 weeks for 14 weeks) or plus levothyroxine sodium if subclinical hypothyroidism; Subjects in control group (28 cases) were treated with observation or oral levothyroxine sodium for 9 months to maintain normal levels of free T4 and sensitive TSH in serum. Serum FT3, FT4, STSH, TPOAb, TGAb and other parameters were evaluated at the beginning of treatment and the first,third,fifth and the last month. Endpoint was the time of the occurring of overt hypothyroidism.Results:In the prednisone group,25 cases completed the treatment, and at the end of study, the incidence of overt hypothyroidism was 4%, and the rest were euthyroid or subclinical hypothyroidism. In the control group,27 cases completed the study, and the incidence of overt hypothyroidism was 7.41%, and the rest were euthyroid or subclinical hypothyroidism. Compared with the control group, the treatment of prednisone group was proved more effective in reducing the titres of thyroid peroxidase and antithyroglubulin antibodies in serum and shrinking goiter and improving the neck appearance. There were no major side effects in 2 groups.Conclusion:In early stage of Hashimoto thyroiditis,Oral prednisone has two advantages:1. Slowing down or even halting the thyroiditis dysfunction.2. Reducing the sizes of enlarged thyroid glands obviously.