Thyroid-Stimulating Immunoglobulins and the Control of Thyroid Function

Clague, R B; Mukhtar, E. D.; Pyle, G.; Nutt, J E; Clark, F.; Scott, M.; Evered, David; Smith, B. R.; Hall, R.

doi:10.1210/jcem-43-3-550

Cited by 60 publications

(9 citation statements)

References 21 publications

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“…Clague et al suggested a correlation between TRAb titers and fT4 levels at the time of diagnosis [30]. Our data didn't confirm this hypothesis; we believe, as already suggested by others [31,32], that in spite of TRAb fundamental role in the etiopathogenesis of GD, many other biochemical signals produced by the immunological cells can modulate the synthesis and the excretion of thyroid hormone.…”

Section: Discussioncontrasting

confidence: 74%

Prognostic Value of Thyrotropin Receptor Antibodies (TRAb) in Graves' Disease: A 120 Months Prospective Study

et al. 2007

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Abstract. In most trials, at least 30-60% of patients with Graves' disease treated with antithyroid drugs relapse within 2 years after therapy withdrawal. At present, there are no prognostic parameters available early in treatment to indicate patients likely to achieve long-term remission. Because thyrotropin receptor autoantibodies (TRAb) are specific for Graves' disease, we evaluated the ability of their levels and of their rate of change to predict long-term prognosis. In our study 216 consecutive patients with newly diagnosed Graves' disease started a therapy with methimazole. Patients were treated until they achieved euthyroidism and TRAb were measured at 6-month intervals throughout a follow up of 120 months. Our study demonstrated that at the onset of hyperthyroidism patients' age, sex, fT4 levels and goiter size had no prognostic value in predicting long-term prognosis (respectively p = 0.79; p = 0.98; p = 0.83; p = 0.89). On the contrary, at the time of diagnosis TRAb titer was a good predictor of the final outcome (p<0.001); a titer equal to (or) more than 46.5 UI/L could identify patients who had never achieved long-term remission with a sensitivity of 52% and a specificity of 78%. Also fall rate of TRAb at 6 months of follow up and after therapy withdrawal were useful to predict the final outcome (p<0.001). At 6 months of follow up the time of therapy withdrawal, a decrease of TRAb lower than 52.3% or even its increase could identify patients who had never achieved permanent remission with a sensitivity of 55% and a specificity of 79.1%. No single parameter among TRAb, satisfactory identified a sub-set of patients who achieved long remission. Accordingly to our data, the best result in predicting long term remission is probably given by the presence of at least one of the two features evaluated at 6 months (TRAb titer and/or percentage of TRAb fall rate), with a sensitivity of 63% and specificity of 88%. TRAb titers evaluated both at the onset of hyperthyroidism that at 6 months of therapy or their rate of fall at 6 months and at ATD withdrawal are predictors of outcome. However, the presence of at least one, between titers of TRAb or their rate of fall at six months, resulted to be the best predictor of remission with the higher sensitivity and specificity.

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Section: Discussioncontrasting

confidence: 74%

Prognostic Value of Thyrotropin Receptor Antibodies (TRAb) in Graves' Disease: A 120 Months Prospective Study

et al. 2007

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“…It is known that relatives of Graves' patients may have immunologic abnormalities: about 25% may have positive LATS levels; some patients may have abnormal thyroid function tests, TRH stimulation tests, and/or T 3 suppression tests (283)(284)(285)(286)(287)(288)(289)(290). Wall et al in 1969 (284), reported the prevalence of TSH receptor antibodies in relatives of Graves' disease patients was 23%.…”

Section: Specificity Of Tsh Receptor Antibodies For Graves' Diseasementioning

confidence: 99%

Immune Mechanisms In Graves' Disease

1985

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“…Most immunoglobulins from untreated Graves' patients competitively inhibit the binding of 125I-TSH to the TSH receptor, and these immunoglobulin activities have been reported to correlate well with thyroid function. Such activities have been called Thyroid Stimulating Immunoglobulins (Smith et al, 1974;Zakarija et al, 1980;Clauge et al, 1976).…”

mentioning

confidence: 99%

A predicted case with neonatal transient hypothyroidism due to blocking type thyrotropin binding inhibitor immunoglobulins (TBII)

Ishihara¹,

Waseda²,

Ikekubo³

et al. 1985

Endocrinol Japon

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A 26-yr-old female with primary hypothyroidism due to potent blocking type thyrotropin binding inhibitor immunoglobulins (TBII) was advised of the high risk of bearing a baby with neonatal transient hypothyroidism. This prediction proved valid and her baby was found to be hypothyroid with a potent TBII.By expressing the baby's TBII as the absolute concentration, we found an almost linear regression of TBII and the half-life was calculated as 18.0 days.The TBII became undetectable by the 6th month and thyroid medicatio was stopped, however the baby remained euthyroid with subsequent normal physical and mental development.

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Thyroid-Stimulating Immunoglobulins and the Control of Thyroid Function

Cited by 60 publications

References 21 publications

Prognostic Value of Thyrotropin Receptor Antibodies (TRAb) in Graves' Disease: A 120 Months Prospective Study

Prognostic Value of Thyrotropin Receptor Antibodies (TRAb) in Graves' Disease: A 120 Months Prospective Study

Immune Mechanisms In Graves' Disease

A predicted case with neonatal transient hypothyroidism due to blocking type thyrotropin binding inhibitor immunoglobulins (TBII)

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