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Graves' disease: immunological and immunogenetic indicators of relapse

The use of measurements of antibody to the thyroid stimulating hormone receptor and HLA-DR3 phenotype for predicting relapse of hyperthyroidism in patients with Graves' disease receiving medical treatment is controversial. Fifty eight new patients with Graves' disease were followed up pros...

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Bibliographic Details
Published in:BMJ 1988-05, Vol.296 (6632), p.1292-1295
Main Authors: de Bruin, T W A, Bolk, J H, Bussemaker, J K, Stijnen, T, Schreuder, G M T, de Vries, R R P, van der Heide, D
Format: Article
Language:English
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Summary:The use of measurements of antibody to the thyroid stimulating hormone receptor and HLA-DR3 phenotype for predicting relapse of hyperthyroidism in patients with Graves' disease receiving medical treatment is controversial. Fifty eight new patients with Graves' disease were followed up prospectively for up to 96 months after treatment with antithyroid drugs for 12 months. The presence of antibody to the thyroid stimulating hormone receptor before the start of treatment, measured as immunoglobulins inhibiting binding of thyroid stimulating hormone, was not associated with relapse. Patients who remained positive for antibodies after treatment tended to relapse within six months, but no relation with long term relapse was found. HLA-Cw7 but not HLA-DR3 was significantly associated with relapse. The presence of HLA-DR4 was significantly associated with remission and with absence of antibodies to thyroid stimulating hormone receptor. HLA-DR4 may therefore protect against relapse of thyrotoxicosis by immunomodulation triggered by antithyroid drugs, which results in the synthesis of antibodies to the thyroid stimulating hormone receptor being inhibited.
ISSN:0267-0623
0959-8138
1468-5833
DOI:10.1136/bmj.296.6632.1292