Thyrotrophin receptor antibody concentration and activity, several years after treatment for Graves’ disease

Summary Objective TSH receptor antibodies (TRAb) are responsible for autoimmune hyperthyroid disease (Graves’ disease; GD) with TRAb levels tending to decrease following treatment. Measurement of TRAb activity during follow‐up could prove valuable to better understand treatment effectiveness. Study...

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Vydané v:	Clinical endocrinology (Oxford) Ročník 90; číslo 2; s. 369 - 374
Hlavní autori:	Nalla, Preethi, Young, Stuart, Sanders, Jane, Carter, Joanne, Adlan, Mohamed A., Kabelis, Katarzyna, Chen, Shu, Furmaniak, Jadwiga, Rees Smith, Bernard, Premawardhana, Lakdasa D. K. E.
Médium:	Journal Article
Jazyk:	English
Vydavateľské údaje:	England Wiley Subscription Services, Inc 01.02.2019
Predmet:	Adult Autoantibodies - blood Carbimazole - therapeutic use Female Graves Disease - etiology Graves Disease - immunology Graves Disease - surgery Graves Disease - therapy Graves' disease Graves’ disease treatment Humans Iodine Radioisotopes - therapeutic use Male Middle Aged Patients Receptors, Thyrotropin - immunology Surgery thyrotrophin receptor antibodies Time Factors Graves’ disease treatment thyrotrophin receptor antibodies
ISSN:	0300-0664, 1365-2265, 1365-2265
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Shrnutí:	Summary Objective TSH receptor antibodies (TRAb) are responsible for autoimmune hyperthyroid disease (Graves’ disease; GD) with TRAb levels tending to decrease following treatment. Measurement of TRAb activity during follow‐up could prove valuable to better understand treatment effectiveness. Study design TRAb concentration and stimulating (TSAb) and blocking (TSBAb) activity of patient serum were assessed following different treatment modalities and follow‐up length. Methods Sixty‐six subjects were recruited following treatment with carbimazole (n = 26), radioiodine (n = 27) or surgery (n = 13). TRAb, TPOAb, TgAb and GADAb were measured at a follow‐up visit as well as bioassays of TSAb and TSBAb activity. Results Forty‐five per cent of all patients remained TRAb‐positive for more than one year and 23% for more than 5 years after diagnosis, irrespective of treatment method. Overall, TRAb concentration fell from a median (IQR) of 6.25 (3.9‐12.7) to 0.65 (0.38‐3.2) U/L. Surgery conferred the largest fall in TRAb concentration from 11.4 (6.7‐29) to 0.58 (0.4‐1.4) U/L. Seventy per cent of TRAb‐positive patients were positive for TSAb, and one patient (3%) was positive for TSBAb. TRAb and TSAb correlated well (r = 0.83). In addition, 38/66 patients were TgAb‐positive, 47/66 were TPOAb‐positive and 6/66 were GADAb‐positive at follow‐up. Conclusions TRAb levels generally decreased after treatment but persisted for over 5 years in some patients. TRAb activity was predominantly stimulatory, with only one patient demonstrating TSBAb. A large proportion of patients were TgAb/TPOAb‐positive at follow‐up. All treatment modalities reduced TRAb concentrations; however, surgery was most effective.
Bibliografia:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 14 content type line 23
ISSN:	0300-0664 1365-2265 1365-2265
DOI:	10.1111/cen.13908