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In this hypermetabolic state, the body releases a large number of reactive oxygen species (ROS), which can lead to thyroid epithelial cell damage, autoantigen activation of the immune system, and induction of autoimmune deterioration

Horstmann M, Kwol M, Amend B et al: A self-reported long-term follow-up of patients operated with either shortening techniques or a TachoSil grafting procedure