Lymphocytic Infiltration of The Thyroid Gland in Relation to The Clinical and Biochemical Parameters in Thyrotoxicosis

Background: Thyrotoxicosis is a clinical condition induced by tissue exposure to excess free thyroid hormones, especially thyroxine (T4) and/or triiodothyronine (T3). Aim: This study aimed to determine the relation between the lymphocytic infiltration degree and the postoperative manifestations of either recurrence or hypothyroidism. Patients and methods: This prospective comparative research was performed on one hundred cases of thyrotoxic goiter admitted to Mansoura University Endocrine Surgery Unit from December 2021 to December 2023. Results: The lymphocytic infiltration degree in the removed thyroid specimen was recorded. The majority of our patients were classified as grade 0 in 29 patients (29%), followed by grade 3 in 25 patients (25%), grade 1 in 23 patients (23%) and grade 2 in 23 patients (23%). They were separated into two equal groups. Six patients (12%) in group “A” who underwent total thyroidectomy (TT) showed hypothyroid manifestations, where there was grade 0 and grade 1 lymphocytic infiltration in specimens which can be corrected by giving levothyroxine (Eltroxin™). Four patients (8%) in group “B” who underwent near total thyroidectomy (NTT) showed recurrence of thyrotoxic manifestations where there was grade 2 and grade 3 lymphocytic infiltration in specimens which can be corrected by radioactive Iodine (RAI). Conclusion: Postoperative hypothyroidism was detected in 12 patients with mild lymphocytic infiltration after TT, while recurrence was observed in 8 patients with heavy lymphocytic infiltration after NTT in patients with thyrotoxic goiter.