Incidence of Postradioiodine Immunogenic Hyperthyroidism/Graves' Disease in Relation to a Temporary Increase in Thyrotropin Receptor Antibodies After Radioiodine Therapy for Autonomous Thyroid Disease

Thyroid ◽  
2006 ◽  
Vol 16 (3) ◽  
pp. 281-288 ◽  
Author(s):  
Matthias Schmidt ◽  
Eva Gorbauch ◽  
Markus Dietlein ◽  
Michael Faust ◽  
Hartmut Stützer ◽  
...  
Keyword(s):  
Thyroid Disease ◽  
Radioiodine Therapy ◽  
Temporary Increase ◽  
Graves Disease ◽  
Thyrotropin Receptor ◽  
Thyrotropin Receptor Antibodies ◽  
Immunogenic Hyperthyroidism ◽  
Receptor Antibodies

scholarly journals Prospective Trial of Functional Thyrotropin Receptor Antibodies in Graves Disease

2019 ◽  
Vol 105 (4) ◽  
pp. e1006-e1014 ◽  
Author(s):  
George J Kahaly ◽  
Tanja Diana ◽  
Michael Kanitz ◽  
Lara Frommer ◽  
Paul D Olivo
Keyword(s):  
Predictive Value ◽  
Prospective Trial ◽  
Thyroid Stimulating Hormone ◽  
Luciferase Expression ◽  
Graves Disease ◽  
Thyrotropin Receptor ◽  
Tertiary Referral Center ◽  
Thyrotropin Receptor Antibodies ◽  
Receptor Antibodies

Abstract Context Scarce data exist regarding the relevance of stimulatory (TSAb) and blocking (TBAb) thyrotropin receptor antibodies in the management of Graves disease (GD). Objective To evaluate the clinical utility and predictive value of TSAb/TBAb. Design Prospective 2-year trial. Setting Academic tertiary referral center. Patients One hundred consecutive, untreated, hyperthyroid GD patients. Methods TSAb was reported as percentage of specimen-to-reference ratio (SRR) (cutoff SRR < 140%). Blocking activity was defined as percent inhibition of luciferase expression relative to induction with bovine thyrotropin (TSH, thyroid stimulating hormone) alone (cutoff > 40% inhibition). Main Outcome Measures Response versus nonresponse to a 24-week methimazole (MMI) treatment defined as biochemical euthyroidism versus persistent hyperthyroidism at week 24 and/or relapse at weeks 36, 48, and 96. Results Forty-four patients responded to MMI, of whom 43% had Graves orbitopathy (GO), while 56 were nonresponders (66% with GO; P < 0.01). At baseline, undiluted serum TSAb but not thyroid binding inhibitory immunoglobulins (TBII) differentiated between thyroidal GD-only versus GD + GO (P < 0.001). Furthermore, at baseline, responders demonstrated marked differences in diluted TSAb titers compared with nonresponders (P < 0.001). During treatment, serum TSAb levels decreased markedly in responders (P < 0.001) but increased in nonresponders (P < 0.01). In contrast, TBII strongly decreased in nonresponders (P = 0.002). All nonresponders and/or those who relapsed during 72-week follow-up period were TSAb-positive at week 24. A shift from TSAb to TBAb was noted in 8 patients during treatment and/or follow-up and led to remission. Conclusions Serum TSAb levels mirror severity of GD. Their increase during MMI treatment is a marker for ongoing disease activity. TSAb dilution analysis had additional predictive value.

scholarly journals Second Generation Assay for Thyrotropin Receptor Antibodies Has Superior Diagnostic Sensitivity for Graves’ Disease

1999 ◽  
Vol 84 (1) ◽  
pp. 90-97 ◽  
Author(s):  
Sabine Costagliola ◽  
Nils G. Morgenthaler ◽  
Rudolf Hoermann ◽  
Klaus Badenhoop ◽  
Joachim Struck ◽  
...  
Keyword(s):  
Second Generation ◽  
Diagnostic Sensitivity ◽  
Graves Disease ◽  
Thyrotropin Receptor ◽  
Thyrotropin Receptor Antibodies ◽  
Receptor Antibodies
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