scholarly journals A Case of Marine-Lenhart Syndrome with a Negative TSH Receptor Antibody Titer Successfully Treated with a Fixed, Low Dose of I131

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Masahiro Takei ◽  
Hiroaki Ishii ◽  
Yoshihiko Sato ◽  
Mitsuhisa Komatsu
Keyword(s):  
Thyroid Gland ◽  
Antibody Titer ◽  
Color Doppler ◽  
Laboratory Data ◽  
Tsh Receptor ◽  
Thyroid Peroxidase ◽  
Graves Disease ◽  
Receptor Antibody ◽  
Tsh Receptor Antibody ◽  
The Right

We herein describe a case of Marine-Lenhart syndrome with a negative TSH receptor antibody titer. A 75-year-old female presented to our hospital with malaise, palpitations, and mild fine tremors. She did not have any signs suggestive of Graves’ ophthalmopathy, including conjunctival injection, periorbital edema, or proptosis. Her laboratory data were negative for thyroid autoantibodies, including anti-thyroid peroxidase antibodies, anti-thyroglobulin antibodies, and anti-TSH receptor antibodies (TRAb). Ultrasonography of the thyroid gland revealed a tumor in the right lobe. The remaining thyroid gland had an inhomogeneous and rough texture with a high color Doppler flow. I123scintigraphy disclosed a hot nodule in the right thyroid gland corresponding to the tumor detected on ultrasonography, suggesting Plummer disease. Furthermore, there was an increased uptake of radionuclide in the rest of the thyroid gland, despite the suppressed level of TSH and negative titer of TRAb, suggesting underlying Graves’ disease. The present findings suggested a diagnosis of Marine-Lenhart syndrome with a negative TRAb titer. Treatment with 10 mCi of radioiodine was highly effective in treating hyperthyroidism in this case. A negative TSH receptor antibody titer does not necessarily rule out the existence of Graves’ disease in patients with Plummer disease.

scholarly journals Determinants of Extraocular Muscle Volume in Patients with Graves' Disease

2012 ◽  
Vol 2012 ◽  
pp. 1-4 ◽  
Author(s):  
Samer El-Kaissi ◽  
Jack R. Wall
Keyword(s):  
Extraocular Muscle ◽  
Tsh Receptor ◽  
Graves Disease ◽  
Thyroid Function Tests ◽  
Thyroid Scintigraphy ◽  
Free T4 ◽  
Receptor Antibody ◽  
Tsh Receptor Antibody ◽  
Antibody Positivity ◽  
Serum Tsh

Background. To examine factors contributing to extraocular muscle (EOM) volume enlargement in patients with Graves’ hyperthyroidism.Methods. EOM volumes were measured with orbital magnetic resonance imaging (MRI) in 39 patients with recently diagnosed Graves’ disease, and compared to EOM volumes of 13 normal volunteers. Thyroid function tests, uptake on thyroid scintigraphy, anti-TSH-receptor antibody positivity and other parameters were then evaluated in patients with EOM enlargement.Results. 31/39 patients had one or more enlarged EOM, of whom only 2 patients had clinical EOM dysfunction. Compared to Graves’ disease patients with normal EOM volumes, those with EOM enlargement had significantly higher mean serum TSH (0.020±0.005versus0.007±0.002mIU/L;Pvalue 0.012), free-T4 (52.9±3.3versus41.2±1.7 pmol/L;Pvalue 0.003) and technetium uptake on thyroid scintigraphy (13.51±1.7%versus8.55±1.6%;Pvalue 0.045). There were no differences between the 2 groups in anti-TSH-receptor antibody positivity, the proportion of males, tobacco smokers, or those with active ophthalmopathy.Conclusions. Patients with recently diagnosed Graves’ disease and EOM volume enlargement have higher serum TSH and more severe hyperthyroidism than patients with normal EOM volumes, with no difference in anti-TSH-receptor antibody positivity between the two groups.

scholarly journals Clinical course of euthyroid subjects with positive TSH receptor antibody: how often does Graves’ disease develop?

2021 ◽  
Author(s):  
Nami Suzuki ◽  
Akiko Kawaguchi ◽  
Jaeduk Yoshimura Noh ◽  
Ran Yoshimura ◽  
Kentaro Mikura ◽  
...  
Keyword(s):  
Thyroid Function ◽  
Clinical Course ◽  
Tsh Receptor ◽  
Graves Disease ◽  
Normal Thyroid ◽  
Receptor Antibody ◽  
Female Patients ◽  
Tsh Receptor Antibody ◽  
Normal Thyroid Function ◽  
Positive Results

Abstract Background Thyroid stimulating hormone (TSH) receptor antibody (TRAb) is detected in the serum of patients with Graves’ disease (GD). This study aims to investigate the prevalence of euthyroid individuals showing positive results for TRAb and to clarify the clinical course of thyroid function and TRAb levels in these subjects. Objective Subjects were female patients who newly visited our hospital for a screening test prior to fertility treatment and showed normal thyroid function and volume without nodules between 2014 and 2017. After excluding subjects with a history of thyroid disease, 5,622 subjects were analyzed. Results Forty-seven of the 5,622 subjects showed positive results for TRAb (reference range, < 2.0 IU/L) at the initial visit. Median initial TRAb was 2.9 IU/L (range, 2.0 -14.7 IU/L) and median follow-up was 18.3 months (range, 0- 66.5 months). Six of the 47 subjects (12.8%) developed GD and median duration until development was 6.6 months (range, 1.2 -13.2 months). Median TRAb values initially and at diagnosisof GD for those 6 patients were 3.7 IU/L (range, 2.7 -5.1 IU/L) and 7.2 IU/L (range 3.6 -21.4 IU/L), respectively. TRAb results turned negative for 20 of the 47 subjects, but remained positive despite normal thyroid function in 13 of the 47 subjects. Conclusion GD developed over time in 12.8% of euthyroid young female patients showing positive TRAb within a median of 6.6 months. A positive result for TRAb itself did not mean development of GD, so other factors must be essential for the pathogenesis of GD.

Disseminated Thyroid Autonomy or Graves' Disease: Reevaluation by a Second Generation TSH Receptor Antibody Assay

Thyroid ◽  
2000 ◽  
Vol 10 (12) ◽  
pp. 1073-1079 ◽  
Author(s):  
J. Meller ◽  
A. Jauho ◽  
M. Hüfner ◽  
S. Gratz ◽  
W. Becker
Keyword(s):  
Second Generation ◽  
Tsh Receptor ◽  
Graves Disease ◽  
Antibody Assay ◽  
Thyroid Autonomy ◽  
Receptor Antibody ◽  
Tsh Receptor Antibody

Measurement of TSH Receptor Antibody in Pregnant Women with Graves’ Disease Predicts Thyroid Function of the Newborn

1998 ◽  
Vol 7 (2) ◽  
pp. 111-114
Author(s):  
Nozomu Sasaki ◽  
Takashi Ohnishi ◽  
Hirokazu Sato ◽  
Kunio Wataki ◽  
Kiyoe Tamaru ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Thyroid Function ◽  
Tsh Receptor ◽  
Graves Disease ◽  
Receptor Antibody ◽  
Tsh Receptor Antibody

scholarly journals The Influence of Prior Hyperthyroidism on Euthyroid Graves’ Ophthalmopathy

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Karolien Termote ◽  
Brigitte Decallonne ◽  
Ilse Mombaerts
Keyword(s):  
Thyroid Hormones ◽  
Tsh Receptor ◽  
Thyroid Peroxidase ◽  
Ocular Motility ◽  
Receptor Antibody ◽  
Tsh Receptor Antibody ◽  
Graves Ophthalmopathy ◽  
Group A ◽  
Group B ◽  
Clinical Records

Background. To investigate the influence of previous exposure to elevated thyroid hormones in euthyroid Graves’ ophthalmopathy.Design. Retrospective, observational case series in university setting Median follow-up of 1 year with ranges of 0,8–7,6 years. Study performance of 10 years.Participants. We reviewed the clinical records of 731 Graves’ ophthalmopathy patients. There were 88 (12%) patients with onset of Graves’ ophthalmopathy during euthyroidism: 37 (5%) patients had ophthalmopathy without known history of thyroid dysfunction (group A) and 51 patients (6%) had onset of ophthalmopathy 6 months or more euthyroid after completion of antithyroid therapy (group B).Main Outcome Measures. Graves’ ophthalmopathy was graded using the EUGOGO severity criteria. Unilaterality was investigated. TSH receptor antibody and thyroid peroxidase antibody were measured as markers of Graves’ disease.Results. Group A had more often a normal ocular motility (46%) and less proptosis (14±4 mm) compared to group B (22%,16±4 mm) (P=0.032and 0.028, resp.). TSH receptor antibody was more frequently elevated in group B (94%) than in group A (17%)(P<0.001).Conclusion. Patients with euthyroid Graves’ ophthalmopathy present more often with ocular muscle restriction and proptosis when previously exposed to elevated thyroid hormones.

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