Serum-negative chronic thyroiditis: an insidious nosographic entity cause of hypothyroidism, goiter and difficult thyroidectomy.
Level 3 - non-randomized controlled study
Retrospective non-randomized cohort study comparing outcomes across clinical groups
PubMed 40736620 · doi:10.1007/s12020-025-04361-1
What was done
A retrospective cohort study was conducted on 476 patients who underwent thyroidectomy between November 2014 and October 2020 at a single surgical division in Naples. Patients were categorized by histopathology and anti-thyroperoxidase/anti-thyroglobulin antibody levels into three groups: without thyroiditis (TF, n = 322), antibody-positive thyroiditis (SPT, n = 116), and seronegative thyroiditis (SNT, n = 38). Rates of preoperative hypothyroidism and postoperative surgical complications were evaluated and compared.
What was found
Preoperative hypothyroidism was documented in 6.2% of the TF group, 33.6% of the SPT group, and 23.7% of the SNT group (p = 0.01 overall; p = 0.31 between SPT and SNT). Transient hypoparathyroidism occurred in 6.5% of TF, 14.7% of SPT, and 13.2% of SNT patients (p < 0.05). No statistically significant differences were observed among groups for permanent hypoparathyroidism, recurrent laryngeal nerve paralysis, or postoperative bleeding.
Why it matters
This study shows that seronegative chronic thyroiditis presents clinical and surgical features similar to classic antibody-positive thyroiditis, including comparable rates of preoperative thyroid dysfunction and transient postoperative hypoparathyroidism.
Limits
The study is limited by its retrospective single-center design and a small seronegative cohort (n = 38), which constrains statistical power for rare surgical complications like permanent hypoparathyroidism and nerve injury. Diagnostic antibody cutoffs and specific surgical indications were not detailed in the abstract.
Cited by
- supports Patients can have autoimmune Hashimoto's thyroiditis with seronegative antibody test results.