Characteristics of anti-TSH receptor antibodies in two patients who developed spontaneous hypothyroidism after antithyroid drug therapy for hyperthyroid Graves' disease.

Kaise, Kazuro; Kaise, Nobuko; Yoshida, K; Itagaki, Yoichi; Yamamoto, Makiko; Sato, Toshiro; Saito, Shintaro; Yoshinaga, Kaoru

doi:10.1620/tjem.152.269

Cited by 2 publications

(2 citation statements)

References 18 publications

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“…Our study raised the question as to how useful the information from measurements of TSH-R-Abs might be in Hashimoto's thyroiditis. Firstly, we found several studies describing that the role of the TSH-R-Abs swings from hypothyroidism to hyperthyroidism and vice versa (30)(31)(32)(33)(34)(35). It appears that Graves' disease with hyperthyroidism might change to a hypothyroid phase that is very similar to AIT (34,35).…”

Section: Discussionmentioning

confidence: 99%

“…Firstly, we found several studies describing that the role of the TSH-R-Abs swings from hypothyroidism to hyperthyroidism and vice versa (30)(31)(32)(33)(34)(35). It appears that Graves' disease with hyperthyroidism might change to a hypothyroid phase that is very similar to AIT (34,35). The opposite of this, i.e., hypothyroidism in Hashimoto's thyroiditis may spontaneously recover or switch to hyperthyroidism just like in Graves' disease (30)(31)(32)(33)36).…”

Section: Discussionmentioning

confidence: 99%

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Frequency Profile and Clinical Correlations of TSH Receptor Antibodies in Euthyroid and Hypothyroid Patients Having Autoimmune Thyroiditis

Mekova¹,

Boyanov²

2019

Turk J Endocrinol Metab

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Objective: The current understanding regarding the clinical significance of TSH receptor antibodies in chronic autoimmune thyroiditis is controversial. The aim of this study was to examine the frequency of elevated TSH receptor antibodies in euthyroid and hypothyroid autoimmune thyroiditis. Furthermore, their associations with the levels of thyroid hormones and autoantibodies (thyroid peroxidase and thyroglobulin antibodies [TgAb]), and the thyroid volume were also investigated. Material and Methods: This cross-sectional study included recently diagnosed euthyroid (N=86) and hypothyroid (N=54) autoimmune thyroiditis patients along with the patients who were on levothyroxine replacement (N=66). The levels of TSH, free T4, free T3, TSH receptor antibodies, thyroid peroxidase, and thyroglobulin antibodies were measured using ECLIA (Roche Diagnostics, Switzerland). A 9 MHz transducer (Fukuda Corp., Japan) for thyroid ultrasound and a 14 MHz transducer (Ultrasonix Medical Corp., Canada) for Doppler ultrasound were employed. Statistical analyses were done with the help of IBM SPSS 19.0 software. Results: The elevated levels of TSH receptor antibodies were observed in 6.3% of the participants (12 females and 1 male) and exclusively in hypothyroid subjects, who were either untreated (7.4%) or on levothyroxine treatment (7.6%). The highest and the lowest prevalence of positive TSH receptor antibodies were seen in patients with positive thyroglobulin antibodies & negative thyroid peroxidase (17.6%) and positive thyroid peroxidase & negative thyroglobulin antibodies (3.3%), respectively. Higher levels of TSH receptor antibodies were associated with a shorter duration of the disease (22 vs. 36 months), lower titers of thyroglobulin antibodies (281.2 vs. 400.9 UI/L), decreased thyroid volumes (9.4 vs. 14.2 cm 3) and an increased prevalence of orbitopathy (23.1 vs. 4.1%). In the whole study population, TSH receptor antibodies levels were related to fT4 (linear R2=0.271, p=0.039), titers of thyroid peroxidase (quadratic, R2=0.048, p=0.034), and thyroid volume (compound R2=0.041, p=0.011). However, in the TSH receptor antibodies positive patients, the correlation was seen only with the levels of thyroid peroxidase (compound R2=0.503, p=0.032). Conclusion: TSH receptor antibodies positivity cannot be considered negligible in Hashimoto's thyroiditis. The elevated levels of TSH receptor antibodies might result in a predisposition to a more unstable thyroid function, lower thyroid volumes, specific profiles of thyroid peroxidase, and thyroglobulin antibodies and a higher prevalence of thyroid-associated ophthalmopathy.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Frequency Profile and Clinical Correlations of TSH Receptor Antibodies in Euthyroid and Hypothyroid Patients Having Autoimmune Thyroiditis

Mekova¹,

Boyanov²

2019

Turk J Endocrinol Metab

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A case of thyrotropin (TSH)-secreting tumor complicated by periodic paralysis.

et al. 1990

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A 27-year-old man had symptoms of hyperthyroidism and periodic paralysis. While hyperthyroid, his serum thyrotropin (TSH) level was inappropriately elevated at 6.4/iU/ml. The serum alpha subunit level was also elevated. MRimaging revealed a pituitary tumor and transsphenoidal adenomectomywas performed. Immunocytochemistry with an antibody directed against the beta-subunit of TSHrevealed a TSH-secreting tumor.This is the first case of hyperthyroidism due to a TSH-secreting pituitary tumor complicated by periodic paralysis. This association indicates that thyrotoxicosis may induce paralysis in susceptible persons by a mechanismwhich is not autoimmune.

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Characteristics of anti-TSH receptor antibodies in two patients who developed spontaneous hypothyroidism after antithyroid drug therapy for hyperthyroid Graves' disease.

Cited by 2 publications

References 18 publications

Frequency Profile and Clinical Correlations of TSH Receptor Antibodies in Euthyroid and Hypothyroid Patients Having Autoimmune Thyroiditis

Frequency Profile and Clinical Correlations of TSH Receptor Antibodies in Euthyroid and Hypothyroid Patients Having Autoimmune Thyroiditis

A case of thyrotropin (TSH)-secreting tumor complicated by periodic paralysis.

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