The Change in 123I-Uptake Between 3- and 24-Hours is Useful in Predicting Early Response to Methimazole in Patients with Graves' Disease.

Gemma, Rieko; Nakamura, Hirotoshi; Mori, Tomoko; Andoh, Shinichirou; Suzuki, Yoshikazu; Takai, Yoshimi

doi:10.1507/endocrj.43.61

Cited by 9 publications

(7 citation statements)

References 14 publications

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“…Although few studies have assessed the associations with responsiveness to anti-thyroid drugs, a previous study reported higher anti-TSH receptor antibody titers in the rapid responder group, but the difference was not statistically significant [13]. Our results showed higher TBII titers were associated with rapid responses in both univariate and multivariate analyses.…”

Section: Discussioncontrasting

confidence: 64%

Free Thyroxine, Anti-Thyroid Stimulating Hormone Receptor Antibody Titers, and Absence of Goiter Were Associated with Responsiveness to Methimazole in Patients with New Onset Graves' Disease

Choi

Yoo

2017

Endocrinol Metab

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BackgroundAnti-thyroid drug therapy is considered a treatment of choice for Graves' disease; however, treatment response varies among individuals. Although several studies have reported risk factors for relapse after initial treatment, few have assessed responsiveness during the early treatment period. Our study aimed to identify the clinical characteristics for responsiveness to methimazole.MethodsWe included 99 patients diagnosed with Graves' disease for the first time. Drug responsiveness was defined as the correlation coefficients between decreasing rates of free thyroxine level per month and methimazole exposure dose. According to their responsiveness to treatment, the patients were classified into rapid or slow responder groups, and age, sex, free thyroxine level, and thyrotropin binding inhibiting immunoglobulin (TBII) titers were compared between groups.ResultsThe mean patient age was 44.0±13.5 years and 40 patients were male (40%). The mean TBII titer was 36.6±74.4 IU/L, and the mean free thyroxine concentration was 48.9±21.9 pmol/L. The rapid responder group showed higher TBII titer and free thyroxine level at diagnosis, while age, sex, smoking, and presence of goiter did not differ between the two groups. Logistic regression analyses revealed that high level of serum thyroxine, high titer of TBII, and absence of goiter were significantly associated with a rapid response, while age, sex, and smoking were not significant factors for the prediction of responsiveness.ConclusionIn patients with new onset Graves' disease, high level of free thyroxine, high titer of TBII, and absence of goiter were associated with rapid responsiveness to methimazole treatment.

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Section: Discussioncontrasting

confidence: 64%

Free Thyroxine, Anti-Thyroid Stimulating Hormone Receptor Antibody Titers, and Absence of Goiter Were Associated with Responsiveness to Methimazole in Patients with New Onset Graves' Disease

Choi

Yoo

2017

Endocrinol Metab

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“…In summary, this patient's perplexing variant of thyrotoxicosis is aptly diagnosed as high iodine turnover or rapid responder Graves' disease. 6 Because this variant of Graves' disease is rarely described and probably confusing to clinicians, our case report thus serves to highlight the existence of this entity and contribute to the limited knowledge base for physicians and endocrinologists.…”

Section: Discussionmentioning

confidence: 92%

“…Such rapid responders demonstrated higher I-123 uptake at three hours when compared with 24 hours. 6 A much less explored alternative plausible hypothesis is the limitation in the other critical substrate (tyrosine) for thyroid hormone production. Importantly, only a few specific rather than all tyrosyl residues within the entire thyroglobulin dimer are amenable to iodination in a sequential pattern determined by the structure of the native protein.…”

Section: Discussionmentioning

confidence: 99%

High iodine (substrate) turnover Graves' disease: the intriguing ‘rapid responder’ variant of thyrotoxicosis

Dalan

Leow

2008

Ann Clin Biochem

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Factors determining the responsiveness to antithyroid drugs (ATDs) in Graves' disease are not fully known. Notwithstanding the typical pattern and tempo of thyroid hormone responses to thionamides, the existence of an unusual subset of Graves' disease with extraordinarily rapid thyroid hormone responses to ATDs will prove challenging even to the expert clinician. Termed 'rapid responder Graves' disease' or 'high turnover Graves' disease', the serum thyroxine (FT4) and triiodothyronine (FT3) of patients with this variant of thyrotoxicosis can decline precipitously during the initiation of ATDs and yet escalate acutely upon discontinuation of pharmacological intervention. We describe a case that presented with low serum FT4 and FT3 in association with suppressed serum thyrotropin (TSH) concentrations soon after starting carbimazole even at a low dose. The erratic clinical course comprising largely of serum FT4 nadirs and peaks is elaborated to facilitate appreciation of the difficulty in the stabilization of the thyroid with ATDs. The possible pathogenetic mechanisms for the chaotic fluctuations in thyroid hormones to minor changes in thionamide dose adjustments are discussed as well.

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“…8 Furthermore, Genna et al reported that rapid or gradual response to treatment was not affected by TRab and TgAb levels. 28 The presence of TPOAb and TgAb antibodies which are known to be diagnostic markers of Hashimoto's thyroiditis, another autoimmune disease at the other end of the spectrum, are also exist in GD. These antibodies have not been investigated as intensely as TRAb or TSAb levels and their effect on relapse remain uncertain.…”

Section: Discussionmentioning

confidence: 99%

Parameters affecting the period for being euthyroid in newly-diagnosed Graves’ disease treated with antithyroid agent

Ekinci

Peynirci

2020

Int J Res Med Sci

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Background: There are limited data about the factors affecting the response time to medical treatment in Graves’ disease (GD) although many studies examined the predictors of the relapse after drug withdrawal. The aim of the current study was to evaluate the time for becoming euthyroid under antithyroid drug (ATD) therapy and the parameters influencing this period in patients diagnosed as GD.Methods: Patients with newly-diagnosed GD and decided to treat with ATD initially between March 2017 and September 2018 were retrieved retrospectively. Sociodemographic features as well as laboratory parameters like thyroid function tests and thyroid-stimulating hormone-receptor antibody (TRab) at the time of diagnosis were recorded.Results: Out of 41 patients, 63.4% (n=26) were female. The mean age was 36.1±11.7 years and 43.9% (n=18) of them were smoking. The time between the initiation of treatment and the duration of becoming euthyroid was 2.4±1.8 months. No significant difference was noted between age, gender, and smoking status and the time to become euthyroid under ATD treatment. This period was significantly positively correlated with levels of free triiodothyronine, free thyroxine, and negatively correlated with thyroid-stimulating hormone. Response to ATD therapy was higher in patients with pre-treatment TRab levels <10 IU/L than TRab ≥10 IU/L (p=0.011).Conclusions: Pretreatment thyroid function tests and TRab levels may be taken into consideration before deciding treatment in patients with newly diagnosed GD. It would be useful to design more comprehensive studies so that this proposal can find a response in clinical practice.

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The Change in 123I-Uptake Between 3- and 24-Hours is Useful in Predicting Early Response to Methimazole in Patients with Graves' Disease.

Cited by 9 publications

References 14 publications

Free Thyroxine, Anti-Thyroid Stimulating Hormone Receptor Antibody Titers, and Absence of Goiter Were Associated with Responsiveness to Methimazole in Patients with New Onset Graves' Disease

Free Thyroxine, Anti-Thyroid Stimulating Hormone Receptor Antibody Titers, and Absence of Goiter Were Associated with Responsiveness to Methimazole in Patients with New Onset Graves' Disease

High iodine (substrate) turnover Graves' disease: the intriguing ‘rapid responder’ variant of thyrotoxicosis

Parameters affecting the period for being euthyroid in newly-diagnosed Graves’ disease treated with antithyroid agent

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