Thyroid Stimulating Immunoglobulins in Patients in Long-Term Remission after Graves' Disease

1984 ◽  
Vol 16 (11) ◽  
pp. 602-605 ◽  
Author(s):  
H. Bliddal ◽  
K. Bech ◽  
C. Kirkegaard
Keyword(s):  
Graves Disease ◽  
Thyroid Stimulating Immunoglobulins

Short- and Long-Term Results of Total vs Subtotal Thyroid- ectomies in the Surgical Treatment of Graves' Disease

Swiss Surgery ◽  
2001 ◽  
Vol 7 (1) ◽  
pp. 20-24 ◽  
Author(s):  
Robert ◽  
Mariéthoz ◽  
Pache ◽  
Bertin ◽  
Caulfield ◽  
...  
Keyword(s):  
Recurrent Laryngeal Nerve ◽  
Nerve Palsy ◽  
Recurrent Laryngeal Nerve Palsy ◽  
Laryngeal Nerve ◽  
Long Term Results ◽  
Graves Disease ◽  
Laryngeal Nerve Palsy ◽  
Short And Long Term

Objective: Approximately one out of five patients with Graves' disease (GD) undergoes a thyroidectomy after a mean period of 18 months of medical treatment. This retrospective and non-randomized study from a teaching hospital compares short- and long-term results of total (TT) and subtotal thyroidectomies (ST) for this disease. Methods: From 1987 to 1997, 94 patients were operated for GD. Thirty-three patients underwent a TT (mostly since 1993) and 61 a ST (keeping 4 to 8 grams of thyroid tissue - mean 6 g). All patients had received propylthiouracil and/or neo-mercazole and were in a euthyroid state at the time of surgery; they also took potassium iodide (lugol) for ten days before surgery. Results: There were no deaths. Transient hypocalcemia (< 3 months) occurred in 32 patients (15 TT and 17 ST) and persistent hypocalcemia in 8 having had TT. Two patients developed transient recurrent laryngeal nerve palsy after ST (< 3 months). After a median follow-up period of seven years (1-15) with five patients lost to follow-up, 41 patients having had a ST are in a hypothyroid state (73%), thirteen are euthyroid (23%), and two suffered recurrent hyperthyroidism, requiring completion of thyroidectomy. All 33 patients having had TT - with follow-ups averaging two years (0.5-8) - are receiving thyroxin substitution. Conclusions: There were no instances of persistent recurrent laryngeal nerve palsy in either group, but persistent hypoparathyroidism occurred more frequently after TT. Long after ST, hypothyroidism developed in nearly three of four cases, whereas euthyroidy was maintained in only one-fourth; recurrent hyperthyroidy was rare.

Sodium ipodate and methimazole in the long-term treatment of hyperthyroid Graves' disease

Metabolism ◽  
1993 ◽  
Vol 42 (4) ◽  
pp. 403-408 ◽  
Author(s):  
Elio Roti ◽  
Eliana Gardini ◽  
Roberta Minelli ◽  
Lina Bianconi ◽  
Lewis E. Braverman
Keyword(s):  
Term Treatment ◽  
Graves Disease ◽  
Long Term Treatment ◽  
Sodium Ipodate

Thyroid Stimulating Immunoglobulins: Measurement and Clinical use

1985 ◽  
Vol 69 (2) ◽  
pp. 113-121 ◽  
Author(s):  
C. A. Ollis ◽  
S. Tomlinson ◽  
D. S. Munro
Keyword(s):  
Thyroid Hormones ◽  
Elevated Serum ◽  
Serum Levels ◽  
The Other ◽  
Graves Disease ◽  
Clinical Use ◽  
Hormone Production ◽  
Skin Changes ◽  
Thyroid Stimulating Immunoglobulins ◽  
Eye Involvement

Graves’ disease is the commonest form of hyperthyroidism in which excessive production of thyroid hormones by the hyperplastic overactive thyroid gland produces elevated serum levels of the thyroid hormones tri-iodothyronine (T3) and thyroxine (T4). Many of the manifestations of Graves’ disease, increased basal metabolic rate, increased heart rate, heat intolerance, sweating and nervousness, can be attributed to the peripheral actions of the excess thyroid hormones. The pathogenesis of many of the other dramatic features of Graves’ disease, such as the eye involvement or localized skin changes, is not fully understood, but circulating immunoglobulins with thyroid stimulating activity are almost certainly linked to excess thyroid hormone production and thereby cause the hyperthyroidism.

scholarly journals Stroke in a Young Man Secondary to Paroxysmal Atrial Fibrillation and Thyrotoxicosis: A Case Report

2017 ◽  
Vol 9 (3) ◽  
pp. 228-233
Author(s):  
Rodrigo Bazan ◽  
Thiago Dias Fernandes ◽  
Gláucia Maria Ferreira da Silva Mazeto ◽  
Mariângela Esther Alencar Marques ◽  
Gabriel Pereira Braga ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Causal Link ◽  
Graves Disease ◽  
Pathological Findings ◽  
Thyroid Scintigraphy ◽  
Normal Heart ◽  
Ectopic Activity ◽  
Resonance Imaging ◽  
Significant Clinical Improvement

We report a case of a male patient with stroke caused by atrial fibrillation (AF) due to thyrotoxicosis. At hospital admission, he presented hypertension and AF. Magnetic resonance imaging confirmed a right-side ischemic area. The thyrotoxicosis was confirmed by thyroid function and thyroid scintigraphy that showed goiter with diffuse hypercaptation. The patient was treated with tapazole and total thyroidectomy, and pathological findings suggested Graves’ disease. Hyperthyroidism is associated with increased supraventricular ectopic activity in patients with a normal heart, and may be an important causal link between hyperthyroidism and AF. The patient experienced significant clinical improvement, but presented long-term neuropsychiatric disorders.

Low-Dose Anti-Thyroid Medication in Graves Disease: Assessment of the Efficacy Based on a Long-Term Follow-Up (Interim Report)

2011 ◽  
pp. P1-684-P1-684
Author(s):  
Hamid Reza Bazrafshan ◽  
Friedrich Fitz ◽  
Martin Steinmair ◽  
Clemens Reichl ◽  
Mohsen Beheshti ◽  
...  
Keyword(s):  
Low Dose ◽  
Disease Assessment ◽  
Graves Disease ◽  
Interim Report ◽  
Thyroid Medication ◽  
Long Term Follow Up

scholarly journals Preserved activation of thyrotropin receptor antibody to stimulate thyroid function despite long-term treatment in euthyroid patients with Graves' disease

1998 ◽  
pp. 281-285 ◽  
Author(s):  
M Akuzawa ◽  
M Murakami ◽  
M Yamada ◽  
T Satoh ◽  
H Shimizu ◽  
...  
Keyword(s):  
Thyroid Function ◽  
Normal Subjects ◽  
Term Treatment ◽  
Graves Disease ◽  
Thyrotropin Receptor ◽  
Receptor Antibody ◽  
Thyrotropin Receptor Antibody ◽  
Long Term Treatment ◽  
Tsh Levels

Clinical evaluation was conducted to ascertain whether thyrotropin receptor antibody (TRAb) in the normal range may still be involved in the regulation of thyroid function after prolonged treatment for Graves' disease. All patients (n = 33) were treated with antithyroid drugs for an average of 10.6 years and were under euthyroid conditions in which normal blood levels of tri-iodothyronine (T3) were significantly correlated with blood thyrotropin (TSH) levels, but not with titers of TRAb. A significant correlation was observed between TRAb titer and thyroid-stimulating antibody (TSAb) activity. In contrast, this correlation was not found in normal subjects. After administration of T3 (75 microg daily for 8 days), the patients showed increased levels of T3 with concomitant suppression of TSH levels. Under these conditions, linear regression analysis showed significant correlations of TRAb titer and TSAb activity with 24-h thyroid radioiodine uptake (r = 0.641 and 0.621 respectively, P < 0.01), in contrast to declining blood thyroxine levels. Moreover, the immunoglobulin G (IgG) of the patients precipitated to a greater extent than IgG from normal subjects a peptide consisting of the amino acid sequence near the terminus of the human TSH receptor. These findings indicated that TRAb at normal levels possessed significant unremitting activities on thyroid function despite long-term treatment in euthyroid patients with Graves' disease.

Objawy oczne w przebiegu chorób tarczycy

2018 ◽  
Vol 21 (1A) ◽  
Author(s):  
Paweł Wójtowiec ◽  
Anna Wójtowiec ◽  
Tomasz Tomkalski
Keyword(s):  
Severe Disease ◽  
Surgical Decompression ◽  
Clinical Activity ◽  
Graves Disease ◽  
Disease Course ◽  
Clinical Activity Score ◽  
Ocular Manifestations ◽  
Ocular Lesions ◽  
Degree Of Severity

Thyroid-related ocular manifestations are typically associated with Graves’ disease. The cause of Graves’ ophthalmopathy is not fully understood but it is believed to be autoimmune in origin. The most important risk factors are smoking and age. Patient’s gender also plays a significant role: ophthalmopathy is more prevalent in women but men experience a more severe disease course. There are two forms of the disease: inflammatory with congestion and pain in the eyeballs and fibrotic stage with impaired eye movements and no signs of inflammation. The degree of severity of ocular lesions is determined by NO SPECS classification and activity coefficient of orbitopathy (Clinical Activity Score – CAS). Previous clinical trials have not produced satysfying answers to questions about effective treatment of orbitopathy. In order to obtain the desired results it is to first necessary to achieve euthyroidism. Treatment is usually continual and long-term. Regimens in various centers vary, depending on their experiences. Currently the most commonly used are steroid therapy, radiation therapy and surgical decompression of the eye sockets. Surgical treatment is, however, used infrequently.

Evaluation of long-term follow-up and methimazole therapy outcomes of pediatric Graves’ disease: a single-center experience

2019 ◽  
Vol 32 (4) ◽  
pp. 341-346 ◽  
Author(s):  
Elvan Bayramoğlu ◽  
Selin Elmaogulları ◽  
Elif Sagsak ◽  
Zehra Aycan
Keyword(s):  
Remission Rate ◽  
Pediatric Population ◽  
Clinical Signs ◽  
Thyroid Stimulating Hormone ◽  
Graves Disease ◽  
Free Triiodothyronine ◽  
Management Options ◽  
Single Center Experience ◽  
Male Sex

Abstract Background The management options for Graves’ disease in children are limited and there is controversy regarding optimal treatment. Remission rate with anti-thyroid drug (ATD) treatment in children is said to be lower than in adults. Definitive treatments are effective, but they often result in permanent hypothyroidism. The objective of this study was to investigate the outcome of methimazole treatment, identify significant predictors of a remission and evaluate the adverse effects of methimazole in a pediatric population of GD patients. Methods Medical records of the patients who had been diagnosed with Graves’ disease were screened retrospectively. Diagnostic criteria included elevated free thyroxine (fT4) and total triiodothyronine (T3), suppressed thyroid-stimulating hormone (TSH) and either positive thyroid-stimulating immunoglobulin (TSI) or thyroid receptor antibodies (TRABs) or clinical signs suggestive of Graves’ disease, for example, exophthalmos. Remission was defined as maintenance of euthyroidism for more than 12 months after discontinuing methimazole treatment. Results Of the 48 patients, provisional remission was achieved in 21 patients. Of the 21 patients, 14 experienced a relapse (66.6%). Remission was achieved in seven (24.1%) of 29 patients who received methimazole treatment for more than 2 years. In patients who achieved long-term remission, the male sex ratio and fT4 levels at diagnosis were significantly lower than the relapsed and non-remission groups, whereas the free triiodothyronine (fT3)/fT4 ratio and duration of methimazole treatment were significantly higher than the relapse group. Conclusions Long-term methimazole treatment in pediatric Graves’ disease would be appropriate. High fT4 levels at the time of diagnosis and male sex were associated with a risk of relapse.

LONG-TERM OUTCOMES OF RADIOIODINE THERAPY FOR JUVENILE GRAVES DISEASE WITH EMPHASIS ON SUBSEQUENTLY DETECTED THYROID NODULES: A SINGLE INSTITUTION EXPERIENCE FROM JAPAN

2020 ◽  
Vol 26 (7) ◽  
pp. 729-737 ◽  
Author(s):  
Tetsuya Mizokami ◽  
Katsuhiko Hamada ◽  
Tetsushi Maruta ◽  
Kiichiro Higashi ◽  
Junichi Tajiri
Keyword(s):  
Thyroid Gland ◽  
Thyroid Nodules ◽  
Radioiodine Therapy ◽  
Antithyroid Drug ◽  
Overt Hypothyroidism ◽  
Graves Disease ◽  
Outpatient Basis ◽  
Long Term Outcomes

Objective: To investigate the long-term outcomes of radioiodine therapy (RIT) for juvenile Graves disease (GD) and the ultrasonographic changes of the thyroid gland. Methods: All of 117 juvenile patients (25 males and 92 females, aged 10 to 18 [median 16] years) who had undergone RIT for GD at our clinic between 1999 and 2018 were retrospectively reviewed. Each RIT session was delivered on an outpatient basis. The maximum 131I dose per treatment was 13.0 mCi, and the total 131I dose per patient was 3.6 to 29.8 mCi (median, 13.0 mCi). 131I administration was performed once in 89 patients, twice in 26, and three times in 2 patients. Ultrasonography of the thyroid gland was regularly performed after RIT. The duration of follow-up after the initial RIT ranged from 4 to 226 (median 95) months. Results: At the latest follow-up more than 12 months after RIT (n = 111), the patients' thyroid functions were overt hypothyroidism (91%), subclinical hypothyroidism (2%), normal (5%), or subclinical hyperthyroidism (2%). New thyroid nodules were detected in 9 patients, 4 to 17 years after initial RIT. Patients with newly detected thyroid nodules underwent RIT with lower doses of 131I and had larger residual thyroid volumes than those without nodules. None of the patients were diagnosed with thyroid cancer or other malignancies during the follow-up period. Conclusion: Over a median follow-up period of 95 months (range, 4 to 226 months), RIT was found to be effective and safe in juvenile GD. However, cumulative evidence from further studies is required to confirm the long-term safety of RIT for juvenile GD. Abbreviations: ATD = antithyroid drug; GD = Graves disease; KI = potassium iodide; LT4 = levothyroxine; MMI = methimazole; PTU = propylthiouracil; RAIU = radio-active iodine uptake; RIT = radioiodine therapy; 99mTc = technetium-99m; TSH = thyrotropin

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