TSH Receptor Antibody Measurements and Prediction of Remission in Graves' Disease Patients Treated with Minimum Maintenance Doses of Antithyroid Drugs

Prediction of remission is one of the main problems of antithyroid drug (ATD) therapy for Graves' disease especially in patients who are treated with a minimum maintenance dose of ATD. We evaluated the ability of new sensitive TSH receptor antibody (TRAb) assays to predict remission in Graves&#...

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Bibliographic Details
Published in:Endocrine Journal 2006, Vol.53(4), pp.467-472
Main Authors: OKAMOTO, Yasuyuki, TANIGAWA, Syun-ichi, ISHIKAWA, Kazuyuki, HAMADA, Noboru
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Antithyroid Agents - administration & dosage
Antithyroid drugs
Autoantibodies - blood
Autoantibody
Female
Graves Disease - blood
Graves Disease - drug therapy
Graves Disease - immunology
Graves' disease
Humans
Immunoglobulins, Thyroid-Stimulating
Male
Methimazole - administration & dosage
Middle Aged
Predictive Value of Tests
Propylthiouracil - administration & dosage
Reagent Kits, Diagnostic
Recurrence
Thyroid
Thyrotropin - blood
Thyroxine - blood
TSH receptor
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Summary:Prediction of remission is one of the main problems of antithyroid drug (ATD) therapy for Graves' disease especially in patients who are treated with a minimum maintenance dose of ATD. We evaluated the ability of new sensitive TSH receptor antibody (TRAb) assays to predict remission in Graves' patients using two commercially available kits (TRAb-CT from Cosmic Corporation and TRAb-Dyno from Yamasa Corporation), compared to the original PEG assay. When a euthyroid state was achieved for more than 6 months with methimazole 5 mg/day or propylthiouracil 50 mg/day and thereafter for three months with 5 mg every other day or 50 mg every other day, respectively, we discontinued ATD medication. One year of observation after discontinuation of ATD was completed in 71 patients (60 females, median age 43 years, range 18-71), and TRAb values from these patients were analyzed in relation to prognosis. Twenty-six (37%) of the 71 patients had relapse of thyrotoxicosis and 45 remained euthyroid. The median TRAb levels in the relapse group were significantly higher than those in the remission group (P
ISSN:0918-8959
1348-4540
DOI:10.1507/endocrj.K05-121