scholarly journals Characteristics of anti-TSH receptor antibodies in two patients who developed spontaneous hypothyroidism after antithyroid drug therapy for hyperthyroid Graves' disease.

1987 ◽  
Vol 152 (3) ◽  
pp. 269-275
Author(s):  
KAZURO KAISE ◽  
NOBUKO KAISE ◽  
KATZUMI YOSHIDA ◽  
YOICHI ITAGAKI ◽  
MAKIKO YAMAMOTO ◽  
...  
Keyword(s):  
Drug Therapy ◽  
Antithyroid Drug ◽  
Tsh Receptor ◽  
Graves Disease ◽  
Antithyroid Drug Therapy ◽  
Receptor Antibodies ◽  
Tsh Receptor Antibodies

Changes in thyroid volume during antithyroid drug therapy for Graves' disease and its relationship to TSH receptor antibodies, TSH and thyroglobulin

1990 ◽  
Vol 123 (4) ◽  
pp. 411-415 ◽  
Author(s):  
Yoshiyuki Yamaguchi ◽  
Toshihiko Inukai ◽  
Akira Iwashita ◽  
Michio Nishino ◽  
Takahiko Yamaguchi ◽  
...  
Keyword(s):  
Drug Therapy ◽  
Antithyroid Drug ◽  
Thyroid Volume ◽  
Graves Disease ◽  
Antithyroid Drug Therapy ◽  
Antithyroglobulin Antibodies ◽  
The Mean ◽  
Receptor Antibodies ◽  
Tsh Receptor Antibodies ◽  
Serum Tsh

Abstract. Changes in thyroid volume during antithyroid drug therapy for Graves' disease compared with circulating thyroid parameters were evaluated. One hundred and forty-four patients with Graves' disease were treated with methimazole. Thyroid volume was measured by ultrasonography (thyroid volume = Π abc/6, where a is length, b width, and c depth). Serum TSH, TSH-binding inhibitory immunoglobulins, thyroid-stimulating antibodies, thyroglobulin, antimicrosomal antibodies, and antithyroglobulin antibodies were also measured. In the whole group of patients, thyroid volume correlated significantly with thyroglobulin (p<0.01) and TSH-binding inhibitory immunoglobulins (p<0.01), but not with TSH, antimicrosomal antibodies, and antithyroglobulin antibodies. Furthermore, a positive correlation was found between thyroglobulin and TSH-binding inhibitory immunoglobulins (p<0.01). In 11 patients the mean thyroid volume decreased significantly after one year of therapy (p<0.01), associated with decreasing levels of serum TSH-binding inhibitory immunoglobulins. Ten patients experienced transient hypothyroidism with an overdose of methimazole, and the mean thyroid volume increased significantly (p<0.01) with increasing serum TSH levels. In conclusion, it is suggested that TSH receptor antibodies may have a thyroid growth-stimulating effect. In addition, circulating thyroglobulin levels reflect thyroid volume in Graves' disease.

A second course of antithyroid drug therapy is effective in patients with relapsed Graves' disease

2018 ◽  
Author(s):  
Khyatisha Seejore ◽  
Fozia Nawaz ◽  
Katherine Kelleher ◽  
Julie Kyaw-Tun ◽  
Julie Lynch ◽  
...  
Keyword(s):  
Drug Therapy ◽  
Antithyroid Drug ◽  
Graves Disease ◽  
Antithyroid Drug Therapy

Successful Treatment of Graves Disease in Pregnancy with Lugol's Iodine

2000 ◽  
Vol 45 (1) ◽  
pp. 20-21 ◽  
Author(s):  
A. Jamieson ◽  
C.G. Semple
Keyword(s):  
Drug Therapy ◽  
Successful Treatment ◽  
Surgical Intervention ◽  
Antithyroid Drug ◽  
Primary Treatment ◽  
Graves Disease ◽  
Lugol’S Iodine ◽  
Organic Iodine ◽  
Antithyroid Drug Therapy ◽  
In Pregnancy

We report a case of Grave's disease in pregnancy complicated by intolerance of standard antithyroid drug therapy. We describe the success of prolonged use of organic iodine as a primary treatment prior to surgical intervention.

Anti-TSH receptor antibodies in Graves' disease modulate the kinetic behaviour of autologous thyroid TSH receptors. Evidence of the IgG-induced cross-linkage of autologous TSH receptors

1984 ◽  
Vol 105 (3) ◽  
pp. 330-340 ◽  
Author(s):  
Tjerk W. A. de Bruin ◽  
Daan van der Heide ◽  
Maria C. Krol
Keyword(s):  
Binding Sites ◽  
Plasma Membranes ◽  
Tsh Receptor ◽  
Human Thyroid ◽  
Graves Disease ◽  
Kinetic Behaviour ◽  
High Affinity ◽  
Cross Linkage ◽  
Receptor Antibodies ◽  
Tsh Receptor Antibodies

Abstract. The effect of the anti-TSH receptor antibodies present in the sera of 8 patients with Graves' disease on the affinity constant (Ka) and the number (R) of TSH receptors in autologous human thyroid plasma membranes was investigated. Kinetic analysis of [125I]bTSH binding to human thyroid plasma membranes in the presence of autologous Graves' and normal gammaglobulins was carried out by means of a computer fitting programme. Analysis of the TSH-TSH receptor interaction in the presence of TSH alone yielded curvilinear Scatchard plots, indicating the existence of two independent classes of binding sites (high affinity Ka: 8.5 ± 4.8 × 108 m−1; low affinity Ka: 5.3 ± 2.7 × 106 m−1). Similarly the Scatchard plot for this interaction in the presence of normal gammaglobulins is also curvilinear. Linear Scatchard plots, indicating the existence of only one class of high affinity TSH binding sites (Ka: 3.5 ± 1.8 × 108 m−1), were obtained for both autologous gammaglobulins and pure IgG from 8 patients with Graves' disease. The number of high affinity TSH binding sites in the presence of Graves' gammaglobulins had increased on the average by a factor 3.76 ± 0.74 (sd) with respect to the number found in the presence of normal gammaglobulins. This marked change in the kinetic behaviour of the TSH binding sites provided evidence that there is a direct interaction between anti-TSH receptor antibodies and autologous TSH receptors. Divalency of Graves' IgG or linkage of Fab fragments by anti-Fab antiserum proved to be necessary to produce this specific change in the kinetic behaviour of TSH binding sites. Graves' IgG monovalent Fab and Fc fragments had no effect. We suggest that the mechanism by which anti-TSH receptor antibodies in Graves' disease mimick the biological action of TSH is the IgG-induced cross-linkage of TSH receptors.

Erratum

1989 ◽  
Vol 121 (2) ◽  
pp. 304
Author(s):  
H. Schleusener ◽  
J. Schwander ◽  
C. Fischer ◽  
R. Holle ◽  
G. Holl ◽  
...  
Keyword(s):  
Drug Therapy ◽  
Relapse Rate ◽  
Clinical Course ◽  
Antithyroid Drug ◽  
Graves Disease ◽  
Trh Test ◽  
Prospective Multicentre Study ◽  
Antithyroid Drug Therapy ◽  
Significant Difference ◽  
The Individual

Abstract. Graves' disease is an autoimmune disease characterized by a course of remission and relapse. Since the introduction of antithyroid drug treatment, various parameters have been tested for their ability to predict the clinical course of a patient with Graves' disease after drug withdrawal. Nearly all these studies were retrospective and often yielded conflicting results. In a prospective multicentre study with a total of 451 patients, we investigated the significance of a variety of routine laboratory and clinical parameters for predicting a patient's clinical course. Patients who had positive TSH receptor antibodies activity at the end of therapy showed a significantly higher relapse rate than those without (P < 0.001). However, the individual clinical course cannot be predicted exactly (sensitivity 0.49, specificity 0.73, N = 391). The measurement of microsomal (P = 0.99, sensitivity 0.37, specificity 0.63, N = 275) or thyroglobulin antibodies (P = 0.76, sensitivity 0.18, specificity 0.84, N = 304) at the end of antithyroid drug therapy did not show a statistically significant difference in the antibody titre between the patients of the relapse and those of the remission group. Additionally, HLA-DR typing (HLA-DR3: P = 0.37, sensitivity 0.36, specificity 0.58, N = 253) was proven to be unsuitable for predicting a patient's clinical course. Patients with abnormal suppression or an abnormal TRH test at the end of antithyroid drug therapy relapse significantly more often (P< 0.001) than patients with normal suppression or normal TRH test. Patients with a large goitre also have a significantly (P< 0.001) higher relapse rate than those with only a small enlargement. The sensitivity and specificity values of all these parameters, however, were too low to be useful for daily clinical decisions in the treatment of an individual patient. This is also true for the combinations of different parameters. Though the highest sensitivity value (0.94) was found for a combination of the suppression and the TRH test at the end of therapy, the very low specificity value (0.13) for this combination reduced its clinical usefulness.

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