scholarly journals Usefulness of the 2nd Generation Assay for Anti-TSH Receptor Antibodies to Differentiate Relapse of Graves' Thyrotoxicosis from Development of Painless Thyroiditis after Antithyroid Drug Treatment for Graves' Disease

2005 ◽  
Vol 52 (4) ◽  
pp. 493-497 ◽  
Author(s):  
Yukiko IZUMI ◽  
Keiko TAKEOKA ◽  
Nobuyuki AMINO
Keyword(s):  
Drug Treatment ◽  
Antithyroid Drug ◽  
Tsh Receptor ◽  
Graves Disease ◽  
2Nd Generation ◽  
Painless Thyroiditis ◽  
Antithyroid Drug Treatment ◽  
Receptor Antibodies ◽  
Tsh Receptor Antibodies

Do HLA-DR-typing and measurement of TSH-receptor antibodies help in the prediction of the clinical course of Graves' thyrotoxicosis after antithyroid drug treatment?

1987 ◽  
Vol 116 (1_Suppl) ◽  
pp. S318-S324 ◽  
Author(s):  
H. Schleusener ◽  
J. Schwander ◽  
G. Holl ◽  
K. Badenhoop ◽  
J. Hensen ◽  
...  
Keyword(s):  
Drug Treatment ◽  
Clinical Course ◽  
Antithyroid Drug ◽  
Tsh Receptor ◽  
Hla Dr ◽  
Number Of Patients ◽  
Antithyroid Drug Treatment ◽  
The Many ◽  
Receptor Antibodies ◽  
Tsh Receptor Antibodies

Abstract. In patients with Graves' hyperthyroidism, the relapse rate after antithyroid drug treatment is in the range of about 30–70%. Different attempts have been made to obtain criteria for the prediction of the clinical outcome after drug therapy, especially HLA-DR typing and measurement of TSH receptor antibodies. So far, very conflicting results have been reported. This is not surprising in view of the many genetically controlled and environmental factors that play a role in the pathogenesis of this disease. Moreover, most reports are based on retrospective studies with a relatively small number of patients. Our own data, obtained in a prospective multicenter study, yield strong evidence against the relevance of HLA-DR3 typing (n = 187, sensitivity = 0.38, specificity = 0.67) or measurement of TSH receptor antibodies at the end of therapy (n = 269, sensitivity = 0.49, specificity = 0.72) for the prediction of the clinical course after drug treatment.

scholarly journals Remission Rate of Graves' Disease and the Trend of Changes in Serum TSH Receptor Antibodies in Prolonged Antithyroid Drug Treatment

2020 ◽  
Vol 18 (Suppl) ◽  
Author(s):  
Danilo Villagelin ◽  
Roberto Bernardo Santos ◽  
João Hamilton Romaldini
Keyword(s):  
Drug Treatment ◽  
Remission Rate ◽  
Antithyroid Drug ◽  
Antithyroid Drugs ◽  
Graves Disease ◽  
Remission Rates ◽  
Thyrotropin Receptor Antibodies ◽  
Antithyroid Drug Treatment ◽  
The Impact ◽  
Receptor Antibodies

Context: Graves’ disease is an autoimmune disease caused by thyrotropin receptor antibodies (TRAb). These antibodies can be measured and used for the diagnosis, prediction of remission, and risk of Graves’ orbitopathy development. There are three treatments for Graves’ disease that have remained unchanged for the last 75 years: Antithyroid drugs, radioiodine, and surgery. Antithyroid drugs are the first treatment option worldwide and are usually used for 12 - 18 months. Recent reports suggest the use of antithyroid drugs for more than 18 months with better outcomes. This review focuses on two aspects of treatment with antithyroid drugs: The impact of using antithyroid drugs for more than 12 - 18 months on remission rates and the trend of TRAb during prolonged antithyroid drug treatment. Evidence Acquisition: A review was performed in Medline on the published work regarding the duration of ATD treatment and remission of Graves' disease and also ATD treatment and TRAb status during the 1990 - 2019 period. Results: Remission rates are variable (30% - 80%), and many clinical and genetic factors serve as predictors. The long-term use of antithyroid drugs appears to increase remission rates. TRAb values usually decline during ATD treatment, but the trend could occur in two ways: Becoming negative or showing a fluctuating pattern. However, approximately 10% of the patients will remain TRAb-positive after five years of treatment with antithyroid drugs. Conclusions: Antithyroid drugs can be used for long periods with an increase in remission rates, and a gradual decrease in TRAb levels, with the disappearance of TRAb in 90% of the patients after 60 months.

Measurement of thyrotropin receptor antibodies (TRAK) with a second generation assay in patients with Graves’ disease

2000 ◽  
Vol 39 (04) ◽  
pp. 113-120 ◽  
Author(s):  
G. Wunderlich ◽  
R. Koch ◽  
W.-G. Franke ◽  
K. Zöphel
Keyword(s):  
Drug Treatment ◽  
Second Generation ◽  
Antithyroid Drug ◽  
Threshold Level ◽  
Optimal Decision ◽  
Graves Disease ◽  
Decision Threshold ◽  
Healthy Controls ◽  
Antithyroid Drug Treatment ◽  
Receptor Antibodies

Summary Aim: The detection of TSH-receptor-antibodies (TRAb) in patients (pts) with Graves’ disease (GD) is routinely used in nuclear medicine laboratories. It is performed by commercial, porcine radioreceptorassays (RRA) measuring TSH binding inhibitory activity. A second generation assay using the human, recombinant TSHreceptor was developed during the last years. The manufacturer composed this new assay as a coated tube RRA (CT RRA) and claimed a higher sensitivity for GD. Methods: TRAb was measured in 207 pts with various thyroid disorders and 205 healthy controls using the new coated tube RRA (Fa. B.R.A.H.M.S. Diagnostica GmbH, Berlin, Germany) as well as a conventional RRA (Fa. Medipan Diagnostica GmbH, Selchow, Germany): 60 pts suffering from GD showing a relapse after antithyroid drug treatment and before radioiodine therapy, 109 pts with disseminated autonomia (DA) and 38 pts suffering from Hashimoto’s thyroiditis. A ROC-analysis was performed to find the optimal decision threshold level for positivity. Results: We found 42/60 TRAbpositive pts with GD in the established RRA (threshold 6 U/L) and 52/60 in the CT RRA, respectively. The sensitivity increased from 70% (RRA) to 86,7% (CT RRA). The CT RRA found 2 false positives (one Hashimoto’s and one healthy control) and the RRA detected 3 Hashimoto’s and 2 healthy controls as false positive. Conclusion: The increased sensitivity of CT RRA for GD provides an advantage compared to conventional RRA, especially in GD-patients relapsing after antithyroid drug treatment. Functional sensitivity and Interassayvariation of CT RRA are very precisely compared to conventional RRA. Handling of the new assay is also improved.

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