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Relationship between thyroid stimulating hormone and thyroid stimulating immunoglobulin in Graves' hyperthyroidism.

AbstractBACKGROUND AND AIM:
In Graves' hyperthyroidism, suppression of serum TSH after restoration of normal serum T4 and T3 with treatment has been attributed to binding of TSH-receptor antibodies to TSH receptors in the pituitary. Accordingly, the relationship between TSH and serum thyroid stimulating immunoglobulin (TSI) was examined during follow-up of patients with Graves' hyperthyroidism.
SUBJECTS AND METHODS:
23 patients with Graves' hyperthyroidism were identified who met the inclusion criteria of at least 24 months follow-up after initiation of methimazole and availability of concurrent measurements of serum TSH and TSI.
RESULTS:
TSI disappeared in 12 patients (Group A) and persisted in 11 patients (Group B). Initial T4 was not significantly different between the 2 groups. However, TSI was significantly lower in Group A than Group B [median (interquartile range) 179 (152-212)% vs 255 (208-369)%, p=0.0009]. In Group A, TSH normalized during treatment, and this anteceded disappearance of TSI by a significant time interval [median (interquartile range) 6 (3-8) months vs 15 (11-20) months, p=0.005]. In Group B, TSI persisted in all patients during follow-up ranging from 24 to 73 months. No correlation was found to exist between serum TSH and TSI, and for Group B TSI at final follow-up was not significantly different from the initial value [median (interquartile range) 255 (208-369)% vs 236 (160-310)%, p=0.4].
CONCLUSIONS:
These findings do not support the suggestion that TSI has a direct suppressive effect on TSH secretion.
AuthorsK A Woeber
JournalJournal of endocrinological investigation (J Endocrinol Invest) Vol. 34 Issue 3 Pg. 222-4 (Mar 2011) ISSN: 1720-8386 [Electronic] Italy
PMID20855936 (Publication Type: Journal Article)
Chemical References
  • Immunoglobulins, Thyroid-Stimulating
  • Thyrotropin
Topics
  • Animals
  • CHO Cells
  • Cricetinae
  • Cricetulus
  • Graves Disease (blood, immunology)
  • Humans
  • Immunoglobulins, Thyroid-Stimulating (blood)
  • Thyrotropin (blood)

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