Abstract | CONTEXT: OBJECTIVES: Our objectives were: 1) to determine the prevalence of TSHR blocking Abs in children and adolescents with CLT and 2) assess their functional significance both in vivo and in vitro. DESIGN AND SETTING: This was a retrospective study in a referral outpatient setting. PATIENTS: Sera from a total of 87 CLT patients and 33 controls were studied. MAIN OUTCOME MEASURES: TSHR Abs were measured by both ELISA and bioassay. RESULTS: Eight of 87 children and adolescents with CLT (9.2%), including one as young as 4 yr of age, had TSHR Abs in serum as measured by ELISA. The prevalence was significantly higher in individuals whose serum TSH concentration was 20 mU/liter or greater within 3 months of study than in less hypothyroid patients (eight of 45 vs. none of 42, P < 0.005). Conversely, TSHR Ab-positive patients were significantly more hypothyroid at diagnosis but only when the analysis was restricted to those with severe hypothyroidism was a decreased prevalence of goiter observed. IgG purified from TSHR Ab sera retained the TSH binding-inhibitory activity and TSHR Ab-positive sera inhibited TSH-induced stimulation of cAMP significantly more than normal. CONCLUSIONS: TSHR-blocking Abs contribute significantly to the severity of the hypothyroidism in some children with CLT, but as compared with adults, they appear to play less of a role in determining the presence or absence of a goiter.
|
Authors | Shiri B Feingold, Jessica Smith, Jeff Houtz, Erica Popovsky, Rosalind S Brown |
Journal | The Journal of clinical endocrinology and metabolism
(J Clin Endocrinol Metab)
Vol. 94
Issue 12
Pg. 4742-8
(Dec 2009)
ISSN: 1945-7197 [Electronic] United States |
PMID | 19850692
(Publication Type: Journal Article)
|
Chemical References |
- Antibodies, Blocking
- Immunoglobulin G
- Receptors, Thyrotropin
- Thyroid Hormones
- Thyrotropin
|
Topics |
- Adolescent
- Adult
- Antibodies, Blocking
(analysis)
- Child
- Child, Preschool
- Chronic Disease
- Enzyme-Linked Immunosorbent Assay
- Female
- Humans
- Immunoglobulin G
(analysis, biosynthesis)
- Longitudinal Studies
- Male
- Receptors, Thyrotropin
(antagonists & inhibitors, immunology)
- Thyroid Function Tests
- Thyroid Hormones
(blood)
- Thyroiditis, Autoimmune
(immunology)
- Thyrotropin
(antagonists & inhibitors)
|