Measuring <scp>TSH</scp> receptor antibody to influence treatment choices in Graves’ disease

Shyamasunder, Asha Hesarghatta; Abraham, Prakash

doi:10.1111/cen.13327

Cited by 45 publications

(16 citation statements)

References 33 publications

(47 reference statements)

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“…TRAb is a hallmark of GH. It is a diagnostic marker of the disease [20], a prognostic marker of relapse after remission [7, 21], and a risk marker of developing Graves' orbitopathy [22]. With the present study we confirmed that TRAb was a prognostic marker and showed that patients with lower TRAb were at higher risk of overtreatment (elevated TSH).…”

Section: Discussionsupporting

confidence: 81%

Predictors of Initial and Sustained Remission in Patients Treated with Antithyroid Drugs for Graves’ Hyperthyroidism: The RISG Study

Karmisholt

Andersen

Bulow-Pedersen

et al. 2019

Journal of Thyroid Research

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Purpose. To study predictors of attaining (part 1) and sustaining (part 2) remission in patients with Graves' hyperthyroidism (GH) treated with antithyroid drugs (ATD). Methods. In the prospective first part, the included patients were treated with ATD until a prespecified definition of remission (thyrotropin > 0.4 mU/L and TSH-receptor antibodies (TRAb) ≤ 1. 0 IU/L in a patient receiving a methimazole dose ≤ 5 mg/day, on two occasions two months apart) was met, or for 24 months. In the second part, patients attaining remission in part 1 were randomized to treatment or observation and followed until relapse or for 24 months. Results. 173 patients completed study 1 and 53% attained remission. TRAb and age were the only significant predictors of remission. Patients with baseline TRAb below vs above 10 IU/L attained remission in 63% compared to 39%, and 5 months priorly (p<0.001). In study 2, 96.4% of the patients randomized to treatment (n=33) sustained remission compared to 66% in the observation group (n=33). Treatment arm was the only significant parameter (p<0.001) of sustained remission. Conclusion. Baseline TRAb was prognostic for attaining remission in GH. Consecutive TRAb measurements during treatment were not worthwhile, but a single measurement after 6-8 months in patients with initial TRAb < 10 IU/L could substantially shorten the treatment period in a subgroup of patients. Only 3.6% of the patients in remission experienced relapse during follow-up when treated with a combination of fixed low dose methimazole and L-T4. ClinTrial.gov registration number is NCT00796913.

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Section: Discussionsupporting

confidence: 81%

Predictors of Initial and Sustained Remission in Patients Treated with Antithyroid Drugs for Graves’ Hyperthyroidism: The RISG Study

Karmisholt

Andersen

Bulow-Pedersen

et al. 2019

Journal of Thyroid Research

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“…Thyrotropin receptor autoantibody showed the highest sensitivity and specificity for diagnosing the disease. 31 , 32 The increasing sensitivity of TRAb is mainly because of its destructive role in the pathophysiological mechanism involved in the disease. 11 …”

Section: Discussionmentioning

confidence: 99%

Graves Disease in Central Ghana: Clinical Characteristics and Associated Factors

Sarfo‐Kantanka

Ansah

Kyei

2018

Clin Med Insights Endocrinol Diabetes

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BackgroundGraves disease (GD) has increased in prevalence over the past decade in Africa. Despite this, the condition is not well described, especially in sub-Saharan Africa.ObjectiveWe have described the clinical characteristics and associated factors of GD in a cohort of patients attending a resource-limited setting tertiary hospital.MethodsPatients were examined thoroughly and systematically tested for the degree of clinical and biochemical thyroid status. Thyroid volume, characteristics, and blood flow were assessed at presentation using ultrasonography. Factors associated with an inability to achieve clinical and biochemical thyroid remission were evaluated using multiple logistic regression analysis.ResultsOverall, 182 patients were studied, 152 (83.5%) were women with a female:male ratio of 5.1:1.0. The mean age at presentation was 39.9 ± 14.7 years with women significantly older than men. Thyroid-associated orbitopathy (TAO) was observed in 56% of the participants and pretibial myxoedema in 6%. About 84% of the participants were hyperthyroid at presentation, 9% were euthyroid, 4% were hypothyroid, and 3% had subclinical hyperthyroidism. Inability to achieve biochemical and clinical remission at 24 months was associated with increased thyroid volume (odds ratio [OR]: 2.35, 95% confidence interval [CI]: 1.85-2.52, P < .001), presence of TAO (OR: 2.15, 95% CI: 2.12-2.33, P < .001), increased FT3/FT4 ratio (OR: 1.33, 95% CI: 1.24-2.56, P = .004), and missed clinic appointment (OR: 5.2, 95% CI: 4.55-7.89, P < .001).ConclusionsGraves disease among Ghanaians is associated with significant signs at presentation. Inability to achieve remission within the first 24 months is associated with increased thyroid volume, TAO, an increased FT3/FT4 ratio, as well as missed clinic appointment.

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“…The CD74 SNP rs2569103 was located within the upstream region of CD74 and showed the strongest association with the disease, making it a possible target for transcription factors. Indeed, the putative transcription factor-binding sites were predicted using PROMO [ 32 , 33 ]. At SNP rs2569103, the A allele generates motifs for nuclear receptor subfamily 3, group C, member 1 (NR3C1) (TC A GG), whereas the G allele generates a motif for forkhead box P3 (FOXP3) (GTTTC G ).…”

Section: Resultsmentioning

confidence: 99%

Association of variant on the promoter of cluster of differentiation 74 in graves disease and graves ophthalmopathy

2020

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The macrophage migration inhibitory factor (MIF)/cluster of differentiation 74 (CD74) plays a role in immunological functions. This study aims to investigate whether single nucleotide polymorphisms (SNPs) in the MIF and CD74 are risk factors for developing Graves ophthalmopathy (GO) in patients with Graves disease (GD). A case-control study enrolled 484 patients with GD (203 with and 281 without GO) and 1000 healthy individuals. SNPs were discriminated using real-time polymerase chain reaction. Hardy-Weinberg equilibrium, as well as frequencies of allele and genotype between GD patients with and without GO, were estimated using the Chi-square test. The effects of CD74 on adipocyte proliferation and differentiation were evaluated using 3T3-L1 preadipocytes. Quantitative DNA-immunoprecipitation was used to detect the binding capacity of NR3C1 and FOXP3 to A/G oligonucleotides. The results showed that individuals carrying the GG genotype at rs2569103 in the CD74 had a decreased risk of developing GD (p = 3.390 ´ 10-11, odds ratio (OR) = 0.021, 95% confidence interval (CI) = 0.003–0.154); however, patients with GD carrying the AG genotype at rs2569103 in the CD74 had an increased risk of developing GO (p = 0.009, OR = 1.707, 95% CI = 1.168–2.495). The knockdown of CD74 reduced adipocyte proliferation and differentiation. NR3C1 had a higher affinity for A, whereas FOXP3 had a higher affinity for G of rs2569103. The results suggested the existence of a link between the genetic variation of CD74 promoter and the risk for developing GD and GO, which should be considered in clinical practice.

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Measuring TSH receptor antibody to influence treatment choices in Graves’ disease

Cited by 45 publications

References 33 publications

Predictors of Initial and Sustained Remission in Patients Treated with Antithyroid Drugs for Graves’ Hyperthyroidism: The RISG Study

Predictors of Initial and Sustained Remission in Patients Treated with Antithyroid Drugs for Graves’ Hyperthyroidism: The RISG Study

Graves Disease in Central Ghana: Clinical Characteristics and Associated Factors

Association of variant on the promoter of cluster of differentiation 74 in graves disease and graves ophthalmopathy

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