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High serum thyrotropin-receptor antibody levels predict recurrent hyperthyroidism in patients with Graves’ disease
The background of the study. Hyperthyroidism
caused by Graves’ disease is due to thyroid stimulation by
thyrotropin (TSH)-receptor-stimulating antibodies (TSHR-Abs). In
this study the predictive value of measurements of serum TSHR-Abs
using a new assay was tested.
How the study was done. The study subjects were 73 women and 20 men with hyperthyroidism due to Graves’ disease who had been treated with methimazole or carbimazole for five months. At that time, serum TSHR-Abs and serum TSH were measured. The patients were then followed for a median duration of 22 months.
The results of the study. Sixty patients (65 percent) had recurrent hyperthyroidism within 24 months after stopping antithyroid drug therapy, and 33 patients (35 percent) remained euthyroid during a median follow-up period of 17 months.
All patients had high serum TSHR-Ab values at the end of treatment. The median value was 8.6 U/L (range, 1.1 to 150) in the patients who had recurrent hyperthyroidism, and it was 2.1 U/L (range, 1.1 to 22.3) in the patients who remained euthyroid. Twenty-eight of the 29 patients with a value >10 U/L had recurrent hyperthyroidism. At the same time, the median serum TSH value was 0.008 mU/L in the patients who had recurrent hyperthyroidism and 0.20 mU/L in the patients who remained euthyroid.
The conclusions of the study. High serum TSHR-Ab values after antithyroid drug therapy predict recurrent hyperthyroidism in patients with Graves’ disease after cessation of therapy.
The original article. Schott M, Morgenthaler NG, Fritzen R, Feldkamp J, Willenberg HS, Scherbaum WA, Seissler J. Levels of autoantibodies against human TSH receptor predict relapse of hyperthyroidism in Graves’ disease. Horm Metab Res 2004;36:92-6.
Next Article: Antithyroid drug therapy
may be associated with antineutrophil cytoplasmic antibodies
in patients with hyperthyroidism due to Graves’ disease
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| Thyroid Digest Index | | | July 2004 Thyroid Digest |
