Triiodothyronine autoantibodies in Graves' disease: Their changes after antithyroid therapy and relationship with the thyroglobulin antibodies

1990 ◽  
Vol 122 (1) ◽  
pp. 22-28 ◽  
Author(s):  
Pei-Wen Wang ◽  
Miau-Ju Huang ◽  
Rue-Tsuan Liu ◽  
Chung Dar Chen
Keyword(s):  
Thyroid Hormone ◽  
Antigenic Site ◽  
Antithyroid Drugs ◽  
Graves Disease ◽  
Thyroglobulin Antibodies ◽  
Control Subjects ◽  
Antithyroid Therapy ◽  
Positive Antibody ◽  
Antithyroid Treatment

Abstract. Sera of 63 patients with Graves' disease, and 49 control subjects were assayed for T3 autoantibodies by a sensitive radioimmunoassay after being stripped of the endogenous thyroid hormone. T3 autoantibodies were demonstrated in 27% of patients with Graves' disease. After antithyroid treatment, T3 autoantibodies in 75% of the patients with positive antibody before therapy changed to negative titre during a follow-up period of 1 to 12 months. Also, a significant decrease of T3 autoantibodies was observed at 1 month after therapy in all patients who received antithyroid treatment. A further study of T3 autoantibodies and anti-thyroglobulin antibodies showed that the latter were demonstrated in 100% of patients with positive T3 autoantibodies and that T3 autoantibodies existed in about one third of patients with positive anti-thyroglobulin antibodies. The results suggested that T3 autoantibodies could be a subpopulation of the heterogenous anti-thyroglobulin antibodies. Although the fall of T3 autoantibodies in some patients was correlated to that of anti-thyroglobulin antibodies, the overall correlation between T3 autoantibodies and anti-thyroglobulin antibodies was poor. In conclusion: 1. T3 autoantibodies may be suppressed by antithyroid drugs. 2. Being a subpopulation of anti-thyroglobulin antibodies, T3 autoantibodies may be caused by an antigenic site within the big thyroglobulin molecule, whereas their titre was not correlated with that of the overall heterogenous anti-thyroglobulin antibodies.

scholarly journals Myopathy Associated with Treatment of Graves’ Disease

Medicina ◽  
2021 ◽  
Vol 57 (10) ◽  
pp. 1016
Author(s):  
Yoon-Kyung Ji ◽  
Shin-Hee Kim
Keyword(s):  
Creatine Kinase ◽  
Adverse Reaction ◽  
Thyroid Function ◽  
Serum Creatine Kinase ◽  
Free Thyroxine ◽  
Antithyroid Drugs ◽  
Graves Disease ◽  
Pediatric Case ◽  
Antithyroid Treatment

Here, we report a case of an increase in serum creatine kinase (CK) concentration in an 11-year-old girl being treated for Graves’ disease with antithyroid drugs (ATDs). The patient complained of myalgia two weeks after methimazole treatment. Triiodothyronine (T3) and free thyroxine (FT4) levels were normal, but the serum CK level was significantly elevated. After switching to propylthiouracil, the serum CK level decreased to normal, and the myalgia was resolved. The development of myopathy during the treatment of hyperthyroidism may be considered as an adverse reaction of MMI. In this report, we present a rare pediatric case, along with a discussion on the possible causes of myopathy that occurred during the treatment of Graves’ disease. A careful follow-up (serum CK levels and thyroid function) and treatment reassessment should always be considered after antithyroid treatment.

scholarly journals Predictive value of maternal second-generation thyroid-binding inhibitory immunoglobulin assay for neonatal autoimmune hyperthyroidism

2014 ◽  
Vol 171 (4) ◽  
pp. 451-460 ◽  
Author(s):  
Juliette Abeillon-du Payrat ◽  
Karim Chikh ◽  
Nadine Bossard ◽  
Patricia Bretones ◽  
Pascal Gaucherand ◽  
...  
Keyword(s):  
First Generation ◽  
Second Generation ◽  
Antithyroid Drugs ◽  
Graves Disease ◽  
Thyroid Ultrasound ◽  
Second Trimester ◽  
Neonatal Hyperthyroidism ◽  
Fetal Thyroid ◽  
Current Guidelines

ContextHyperthyroidism occurs in 1% of neonates born to mothers with active or past Graves' disease (GD). Current guidelines for the management of GD during pregnancy were based on studies conducted with first-generation thyroid-binding inhibitory immunoglobulin (TBII) assays.ObjectiveThis retrospective study was conducted in order to specify the second-generation TBII threshold predictive of fetal and neonatal hyperthyroidism, and to identify other factors that may be helpful in predicting neonatal hyperthyroidism.MethodsWe included 47 neonates born in the Lyon area to 42 mothers harboring measurable levels of TBII during pregnancy. TBII measurements were carried out in all mothers; bioassays were carried out in 20 cases.ResultsNine neonates were born with hyperthyroidism, including five with severe hyperthyroidism requiring treatment. Three neonates were born with hypothyroidism. All hyperthyroid neonates were born to mothers with TBII levels >5 IU/l in the second trimester (sensitivity, 100% and specificity, 43%). No mother with TSH receptor-stimulating antibodies (TSAb measured by bioassay) below 400% gave birth to a hyperthyroid neonate. Among mothers of hyperthyroid neonates, who required antithyroid drugs during pregnancy, none could stop treatment before delivery. Analysis of TBII evolution showed six unexpected cases of increasing TBII values during pregnancy.ConclusionMaternal TBII value over 5 IU/l indicates a risk of neonatal hyperthyroidism. Among these mothers, a TSAb measurement contributes to identify more specifically those who require a close fetal thyroid ultrasound follow-up. These results should be confirmed in a larger series.

scholarly journals Hyperthyroidism and vascular cell adhesion molecule-1 are associated with a low ankle-brachial index

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Yu-Hsuan Li ◽  
I-Te Lee
Keyword(s):  
Cell Adhesion Molecule ◽  
Regression Coefficient ◽  
Ankle Brachial Index ◽  
Antithyroid Drugs ◽  
Graves Disease ◽  
Vascular Cell Adhesion ◽  
Free T4 ◽  
Vascular Cell ◽  
Cell Adhesion Molecule 1

Abstract We aimed to assess the ankle-brachial index (ABI) in patients with Graves’ disease. In the cross-sectional assessments, 81 patients with drug-naïve Graves’ disease and 235 with euthyroidism were enrolled. ABI and vascular cell adhesion molecule-1 (VCAM-1) levels were assessed. In the prospective follow-up, 32 patients with Graves’ disease were assessed again after antithyroid drugs for at least 4 weeks, and 32 age- and sex-matched controls with euthyroidism were also followed up. Patients with Graves’ disease had a higher VCAM-1 level (1309 ± 292 vs. 1009 ± 168 ng/mL, P < 0.001) and a lower ABI (0.98 ± 0.11 vs. 1.06 ± 0.10, P < 0.001) than those with euthyroidism. ABI was significantly lower in patients with hyperthyroidism and a high VCAM-1 level than in those with euthyroidism and a low VCAM-1 level (regression coefficient: − 0.050, 95% confidence interval [CI] between − 0.080 and − 0.019; P = 0.001). After treatment with antithyroid drugs, the change in free thyroxine (T4) level was inversely associated with the percentage change in ABI (regression coefficient: − 0.003, 95% CI between − 0.005 and − 0.001, P = 0.001). A synergistic effect of VCAM-1 and free T4 on ABI reduction was observed. After a longitudinal follow-up, an increase in ABI was significantly correlated with a decrease in the free T4 level.

scholarly journals Efficacy and safety of radioiodine treatment of Graves’ disease in children and adolescents

2017 ◽  
Vol 13 (1) ◽  
pp. 6-11 ◽  
Author(s):  
Pavel O. Rumiantsev ◽  
Marina S. Sheremeta ◽  
Alexey V. Kiyaev ◽  
Luydmila A. Kurmyshova ◽  
Olga A. Chikulaeva
Keyword(s):  
Children And Adolescents ◽  
Treatment Protocol ◽  
Case Series ◽  
Active Phase ◽  
Research Centre ◽  
Radiology Department ◽  
Antithyroid Drugs ◽  
Graves Disease ◽  
Case Series Study

There are three methods in treatment of Graves’ disease in children and adolescents – antithyroid drugs, surgery and radioiodine therapy (RIT). However, treatment protocol of children and adolescents doesn’t exist. In the present case series study we have evaluated the effectiveness and safety of RIT in children and adolescents. We have observed totally 25 patients in age 11–17 years old (mean 14.8 years) with Graves’ disease. Ten patients were treated with RIT in Endocrinology Research Centre (Moscow) in 2016 year with activities 550–920 MBq. Follow-up period varied 6–11 months in this subgroup. The second subgroup (15 patients) was treated in radiology department in Nijniy Tagil rural hospital (Ural region) in the period 2005–2012 years. Follow-up period varied 3.5–11.5 years (mean 8.5 years). RIT was executed in all patients without any complications, direct or long-term. In two patients having endocrine ophtalmopathy in non-active phase it was no any signs of worsening in result of RIT. In 17 (68%) of 25 patients the hypothyroidism occurred through 6 months. In one case – euthyroidism. In remain 7 observations the hyperthyroidism recurred. Patient subgroups didn’t differ in mean age, gender ratio, thyroid size and autoantibodies to TSH receptor levels, but were differed in treatment 131I activities (subset from ERC – 550–920 MBq; subset from Nijniy Tagil – 168–400 MBq). However the treatment efficacy did not differ significantly (p = 0.99): 68% and 73%, accordingly. In conclusion, RIT of Graves’ disease in a safe and effective method of treatment for hyperthyroidism in children and adolescents. It’s necessary to prolong study in numerous patients cohort, longer-lasting follow-up period as well as to improve RIT efficiency.

Management of thyrotoxicosis in children and adolescents: 35 years’ experience in 304 patients

2018 ◽  
Vol 31 (2) ◽  
pp. 159-165 ◽  
Author(s):  
Fereidoun Azizi ◽  
Atieh Amouzegar
Keyword(s):  
Children And Adolescents ◽  
Treatment Modality ◽  
Radioiodine Therapy ◽  
Thyroid Stimulating Hormone ◽  
Antithyroid Drugs ◽  
Graves Disease ◽  
The Mean ◽  
Toxic Goiter ◽  
Original Treatment

Abstract Background: Diffuse toxic goiter accounts for about 15% of all childhood thyroid diseases. There is great controversy over the management of Graves’ disease in children and adolescents. This article reports our experience in 304 children and juvenile patients with Graves’ disease. Methods: Between 1981 and 2015, 304 patients aged 5–19 years with diffuse toxic goiter were studied, of whom 296 patients were treated with antithyroid drugs (ATD) for 18 months. Patients with persistent or relapsed hyperthyroidism who refused ablative therapy with surgery or radioiodine were managed with continuous methimazole (MMI) treatment. Results: In 304 patients (245 females and 59 males), the mean age was 15.6±2.6 years. After 18 months of ATD therapy, 37 remained in remission and of the 128 who relapsed, two, 29 and 97 patients chose surgery, continuous ATD and radioiodine therapy, respectively. Of the 136 patients who received radioiodine, 66.2% became hypothyroid. Twenty-nine patients received continuous ATD therapy for 5.7±2.4 years. The mean MMI dose was 4.6±12 mg daily, no serious complications occurred and all of them remained euthyroid during the follow-up. Less abnormal thyroid-stimulating hormone (TSH) values were observed in these patients, as compared to patients who were on a maintenance dose of levothyroxine after radioiodine induced hypothyroidism. Conclusions: Original treatment with ATD and subsequent radioiodine therapy remain the mainstay of treatment for juvenile hyperthyroidism. Continuous ATD administration may be considered as another treatment modality for hyperthyroidism.

scholarly journals Thyroid hormone autoantibodies (THAA) in two cases of Graves' disease: Effects of antithyroid drugs, prednisolone, and subtotal thyroidectomy.

1986 ◽  
Vol 33 (6) ◽  
pp. 751-759 ◽  
Author(s):  
SHIGENORI NAKAMURA ◽  
SHIGEKI SAKATA ◽  
HIROTO SHIMA ◽  
TAKASHI KOMAKI ◽  
NORIKO KOJIMA ◽  
...  
Keyword(s):  
Thyroid Hormone ◽  
Subtotal Thyroidectomy ◽  
Antithyroid Drugs ◽  
Graves Disease ◽  
Thyroid Hormone Autoantibodies

ANTITHYROID DRUGS IN THE TREATMENT OF HYPERTHYROIDISM OF Graves' DISEASE: LONG-TERM FOLLOW-UP OF 434 PATIENTS

1989 ◽  
Vol 31 (2) ◽  
pp. 209-218 ◽  
Author(s):  
A. J. HEDLEY ◽  
R. E. YOUNG ◽  
S. J. JONES ◽  
W. D. ALEXANDER ◽  
P. D. BEWSHER ◽  
...  
Keyword(s):  
Antithyroid Drugs ◽  
Graves Disease ◽  
Long Term Follow Up

scholarly journals Decrease in TSH Receptor Autoantibodies during Antithyroid Treatment: Relationship with a Long Noncoding Heg RNA and Cdk1 mRNA in Mononuclear Cells

2011 ◽  
Vol 2011 ◽  
pp. 1-4 ◽  
Author(s):  
Niels Juel Christensen ◽  
Gurli Habekost ◽  
Palle Bratholm
Keyword(s):  
Noncoding Rna ◽  
Mononuclear Cells ◽  
Normal Subjects ◽  
Tsh Receptor ◽  
Antithyroid Drugs ◽  
Graves Disease ◽  
Antithyroid Treatment ◽  
High Concentrations ◽  
Regulation Of Cell Cycle ◽  
Cd14 Mrna

We have previously shown that a long noncoding RNA transcript Heg is negatively correlated with TSH receptor autoantibodies (TRAb) in patients with untreated Graves' disease and with CD14 mRNA in treated patients and controls. Thus patients with high concentrations of Heg RNA have low levels of TRAb or CD14 mRNA, respectively. Here we show that an additional factor, gene expression of Cdk1 in mononuclear cells, is positively related to concentrations of TRAb in patients with untreated Graves' disease. Cdk1 mRNA is very important for regulation of cell cycle activity. It is well known that TRAb decrease significantly during treatment with antithyroid drugs. This decrease during treatment cannot be explained by Heg RNA, which remains unchanged. Cdk1 mRNA decreased significantly during treatment to values below values obtained in normal subjects. Thus both Heg RNA and Cdk1 mRNA may influence the level of TSH receptor autoantibodies but by different mechanisms.

Thyroid hypoechogenic pattern at ultrasonography as a tool for predicting recurrence of hyperthyroidism after medical treatment in patients with Graves' disease

1992 ◽  
Vol 126 (2) ◽  
pp. 128-131 ◽  
Author(s):  
Paolo Vitti ◽  
Teresa Rago ◽  
Francesco Mancusi ◽  
Stefania Pallini ◽  
Massimo Tonacchera ◽  
...  
Keyword(s):  
Antithyroid Drugs ◽  
Graves Disease ◽  
Study Group ◽  
Thyrotropin Receptor ◽  
Thyroid Ultrasonography ◽  
Normal Thyroid ◽  
End Of Treatment ◽  
The Relationship ◽  
Prediction Of Relapse

An abnormal thyroid echographic pattern characterized by a diffuse low echogenicity has been described in Hashimoto's thyroiditis and Graves' disease. The aim of the present work was to study the relationship between thyroid hypoechogenicity and the outcome of treatment for hyperthyroidism with antithyroid drugs in patients with Graves' disease. The study group included 105 patients who underwent a course of methimazole treatment. Thyroid ultrasonography was carried out at diagnosis, and autoantibodies to thyrotropin receptor (TR-ab) were measured at the end of treatment. During the follow-up after methimazole treatment, 87/105 (83%) patients had relapse of hyperthyroidism and 18/105 (17%) were in remission. Recurrence of hyperthyroidism occurred in 71/76 (93%) patients with thyroid hypoechogenicity and in 16/29 (55%) of those with normal thyroid echogenicity (ϰ2= 19.0; p<0.0001). Positive TR-ab values at the end of methimazole treatment were found in 59/76 (78%) patients with thyroid hypoechogenicity and in 12/29 (41%) patients with normal thyroid echogenicity (ϰ2 = 10.9; p< 0.0001). Sixty-five/87 (74%) patients with relapse of hyperthyroidism and 6/18(3 3%) of those who remained euthyroid were TR-ab-positive at the end of methimazole treatment (ϰ2 = 9.8; p< 0.002). The finding of thyroid hypoechogenicity at diagnosis had higher specificity (0.81) and sensitivity (0.72) with respect to TR-ab positivity at the end of methimazole treatment (0.74 and 0.66 respectively) for the prediction of relapse of hyperthyroidism. Therefore, the evaluation of thyroid echographic pattern can be considered a useful prognostic tool in patients with Graves' disease.

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