Clinical, Hormonal, and Ultrasound Characteristics of Patients with Newly Diagnosed Graves’ Disease And Different Thyroid Antibody Profiles

Mekova, R.; Boyanov, Mihail

doi:10.2478/amb-2019-0011

Cited by 4 publications

(4 citation statements)

References 34 publications

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“…In total, 26,803 patients were included in the review and 10,667 were diagnosed with thyroid eye disease (TED). Articles included mainly originated from Europe (n = 28), 22‐49 Asia (n = 20), 50‐69 North America (n = 7), 70‐76 Oceania (n = 1) 77 and South America (n = 1) 78 . Table 1 summarizes the results of the meta‐analysis, and a summary of the included articles can be found in the appendix.…”

Section: Resultsmentioning

confidence: 99%

Prevalence of thyroid eye disease in Graves’ disease: A meta‐analysis and systematic review

Chin

Lee

et al. 2020

Clinical Endocrinology

106

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Objective Thyroid eye disease (TED) is a debilitating condition that frequently manifests in patients suffering from Graves’ disease (GD). This study aims to analyse the prevalence of TED among GD patients, with a focus on geographical region‐specific rates. Methods Medline and Embase were searched for articles examining TED prevalence on April 2020, and articles were retrieved and sieved. Statistical analysis was performed after Freeman‐Tukey double arcsine transformation. Thereafter, results were pooled with random effects by DerSimonian and Laird model. Results Fifty‐seven articles involving 26,804 patients were included in the review. The overall pooled prevalence of TED was 40% (CI: 0.32 to 0.48) and by continent was 38% (CI: 0.31 to 0.46) for Europe, 44% (CI: 0.32 to 0.56) for Asia, 27% (CI: 0.06 to 0.56) for North America and 58% (CI: 0.55 to 0.61) for Oceania. The prevalence of TED in Southeast Asia was 35% (CI: 0.24 to 0.47) and Middle East 48% (CI: 0.19 to 0.78). Subgroup analysis showed regions with predominantly Caucasians (37%; CI: 0.28 to 0.46) had a lower prevalence of TED compared to Asians (45%; CI: 0.33 to 0.58). The pooled prevalence of lid retraction was 57% (CI: 0.39 to 0.74), proptosis 57% (CI: 0.48 to 0.65), diplopia 36% (CI: 0.24 to 0.48) and ocular hypertension 13% (CI: 0.06 to 0.19). Conclusion A substantial proportion of patients with GD have TED and often manifest as lid retraction, proptosis and diplopia. Early detection through active screening might help to mitigate the progression of TED and its associated complications.

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Section: Resultsmentioning

confidence: 99%

Prevalence of thyroid eye disease in Graves’ disease: A meta‐analysis and systematic review

Chin

Lee

et al. 2020

Clinical Endocrinology

106

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“…Smoking [13] and TSH receptor stimulation [14][15][16] are known risk factors for GO. Furthermore, high TRAb levels have been associated with an increased risk of GO [17] as have low levels of TPOAb [18][19][20][21][22] and lower TgAb [19] [22]. In one study, higher TgAb [20] levels were linked to risk of GO.…”

Section: Introductionmentioning

confidence: 99%

Serum thyroglobulin is associated with orbitopathy in Graves’ disease

Khamisi

Lundqvist

Emadi

et al. 2021

J Endocrinol Invest

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Purpose Serum thyroglobulin levels are often elevated in Graves’ disease (GD) and in most cases decrease during treatment. Its relation to Graves’ orbitopathy (GO) has not been clarified. Previously, a risk of GO has been linked to smoking, TSH receptor stimulation, high TSH-receptor antibodies (TRAb), low thyroid peroxidase and thyroglobulin antibodies (TPOAb, TgAb). Methods We examined Tg levels in 30 consecutive patients with GD were given drug therapy (methimazole + thyroxine) for up to 24 months. GO was identified by clinical signs and symptoms. 17 patients had GO, 11 of whom had it at diagnosis while 6 developed GO during treatment. During the study, 5 subjects were referred to radioiodine treatment, 3 to surgery. The remaining 22 subjects (GO n = 12, non-GO n = 10) completed the drug regimen. Results At diagnosis, Tg levels in GO patients (n = 11) were higher (84, 30–555 µg/L, median, range) than in non-GO patients (n = 19) (38, 3.5–287 µg/L), p = 0.042. Adding the 6 subjects who developed eye symptoms during treatment to the GO group (n = 17), yielded p = 0.001 vs. non-GO (n = 13). TRAb tended to be higher, while TPOAb and TgAb tended to be lower in the GO group. For the 22 patients who completed the drug regimen, Tg levels were higher in GO (n = 12) vs. non-GO (n = 10), p = 0.004, whereas TRAb levels did not differ. Conclusion The data may suggest that evaluation of thyroglobulin levels in GD could contribute to identify patients at increased risk of developing GO. Possibly, thyroidal release of Tg in GD reflects a disturbance that also impacts retroorbital tissues.

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“…Mekova and Boyanov found an increased concentration of anti-TPO in 71.4% of patients without nodules among patients with newly diagnosed GD. 24 In contrast to their Table 3. Selected parameters (biochemical data, ThV, age of patients, and applied RAI activity) categorized according to the application of steroid protection.…”

Section: Discussionmentioning

confidence: 86%

Influence of high tissue-absorbed dose on anti-thyroid antibodies in radioiodine therapy of Graves’ disease patients

Listewnik¹,

Piwowarska-Bilska²,

Jasiakiewicz³

et al. 2021

Adv Clin Exp Med

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Background. The results of radioactive iodine (RAI) treatment for Graves' disease (GD) are related to the choice of diagnostic and dosimetry protocols, the steroid protection used, and the subsequent 131 I dose. The effect of a high tissue-absorbed dose on the level of anti-thyroid antibodies (ATA) has been rarely considered.Objectives. To estimate the effect of the first RAI therapy with a dose of 250 Gy on anti-thyreoperoxidase (anti-TPO) and anti-thyroid-stimulating hormone (TSH) receptor thyrotropin receptor antibody -TRAb levels in GD patients. Materials and methods.The analysis encompassed 46 consecutive patients with clinical presentation of GD. We examined the serum levels of TSH, free thyroxine (FT4), anti-TPO, TRAb, thyroid volume (ThV), 131 I effective half-life (EHL), introduction of steroid protection, levothyroxine dose used in thyroid replacement therapy -TRT, and effectiveness of treatment.Results. As a result of RAI treatment, hypothyroidism was found in 35 patients (76.1%), euthyroidism in 7 patients (15.2%) and hyperthyroidism in 4 patients (8.7%). After RAI, we observed ThV reduction and increased anti-TPO (p = 0.001 and p = 0.001, respectively). It was found that a shorter EHL correlated with a higher baseline TRAb concentration and lower final anti-TPO serum concentration (p = 0.03 and p = 0.01, respectively). Lower final TRAb was found in patients with steroid protection (p = 0.049). Intergroup comparison of patients without steroid protection showed significantly higher final anti-TPO concentation (p = 0.02). Intergroup comparison of patients with TRT revealed significantly higher final anti-TPO concentration (p = 0.04). Conclusions.The application of a high absorbed dose of 250 Gy in GD resulted in high efficacy of RAI therapy at 1-year follow-up. An increased ATA level and its relationships with EHL and ThV reduction were observed at 1-year follow-up. There is a possible relationship between steroid protection and anti-TPO concentration.

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Clinical, Hormonal, and Ultrasound Characteristics of Patients with Newly Diagnosed Graves’ Disease And Different Thyroid Antibody Profiles

Cited by 4 publications

References 34 publications

Prevalence of thyroid eye disease in Graves’ disease: A meta‐analysis and systematic review

Prevalence of thyroid eye disease in Graves’ disease: A meta‐analysis and systematic review

Serum thyroglobulin is associated with orbitopathy in Graves’ disease

Influence of high tissue-absorbed dose on anti-thyroid antibodies in radioiodine therapy of Graves’ disease patients

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