Endocrinology and Metabolism

Original Articles

Clinical Study
Changes in Thyroid Peroxidase and Thyroglobulin Antibodies Might Be Associated with Graves' Disease Relapse after Antithyroid Drug Therapy: Yun Mi Choi, Mi Kyung Kwak, Sang Mo Hong, Eun-Gyoung Hong; Endocrinol Metab. 2019;34(3):268-274. Published online September 26, 2019; DOI: https://doi.org/10.3803/EnM.2019.34.3.268

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Background

Graves' disease (GD) is an autoimmune thyroid disorder caused by antibodies stimulating the thyrotropin (TSH) receptor. TSH receptor antibody (TRAb) measurement is useful for predicting GD relapse after antithyroid drug (ATD) treatment. However, the association of other thyroid autoantibodies with GD relapse remains obscure.

Methods

This retrospective study enrolled patients with GD who were initially treated with ATD. TRAb, thyroid peroxidase antibody (TPOAb), and thyroglobulin antibody (TgAb) were measured at the initial diagnosis and at the time of ATD discontinuation.

Results

A total of 55 patients were enrolled. The mean age was 49.7 years, and 39 patients (70.9%) were female. Antibody positivity at diagnosis was 90.9%, 69.1%, and 61.9% for TRAb, TPOAb, TgAb, respectively. Median ATD treatment period was 15.1 months. At the time of ATD withdrawal, TRAb titers decreased uniformly overall. Conversely, TPOAb and TgAb showed various changes. After withdrawal of ATD, 19 patients (34.5%) experienced relapse. No clinical features or laboratory results were significantly related to relapse in the overall patient group. However, in the TPOAb positive group at diagnosis, increasing titer of TPOAb or TgAb after ATD treatment was significantly and independently related to relapse free survival (TPOAb: hazard ratio [HR], 17.99; 95% confidence interval [CI], 1.66 to 195.43; P=0.02) (TgAb: HR, 5.73; 95% CI, 1.21 to 27.26; P=0.03).

Conclusion

Changes in TPOAb or TgAb titers during treatment might be useful for predicting relapse after ATD treatment in patients with positive TPOAb at diagnosis.

Citations

Citations to this article as recorded by

Enhanced predictive validity of integrative models for refractory hyperthyroidism considering baseline and early therapy characteristics: a prospective cohort study
Xinpan Wang, Tiantian Li, Yue Li, Qiuyi Wang, Yun Cai, Zhixiao Wang, Yun Shi, Tao Yang, Xuqin Zheng
Journal of Translational Medicine.2024;[Epub] CrossRef
Clinical significance of thyroglobulin antibodies and thyroid peroxidase antibodies in Graves’ disease: a cross-sectional study
Masahito Katahira, Taku Tsunekawa, Akira Mizoguchi, Mariko Yamaguchi, Kahori Tsuru, Hiromi Takashima, Ryoma Terada
Hormones.2023; 22(2): 253. CrossRef
The Clinical Implications of Anti-thyroid Peroxidase Antibodies in Graves’ Disease in Basrah
Emad S Alhubaish, Nassar T Alibrahim, Abbas A Mansour
Cureus.2023;[Epub] CrossRef
Influence of Thyroid Peroxidase Antibodies Serum Levels in Graves' Disease: A Retrospective Cohort Study
Maria L Guia Lopes, Carlos Tavares Bello, José P Cidade, Clotilde Limbert, Joao Sequeira Duarte
Cureus.2023;[Epub] CrossRef
Interpretation of Thyroid Autoantibodies in Hyperthyroidism
Han-Sang Baek, Dong-Jun Lim
The Korean Journal of Medicine.2023; 98(3): 132. CrossRef
Usefulness of Real-Time Quantitative Microvascular Ultrasonography for Differentiation of Graves’ Disease from Destructive Thyroiditis in Thyrotoxic Patients
Han-Sang Baek, Ji-Yeon Park, Chai-Ho Jeong, Jeonghoon Ha, Moo Il Kang, Dong-Jun Lim
Endocrinology and Metabolism.2022; 37(2): 323. CrossRef
Differential Diagnosis of Thyrotoxicosis by Machine Learning Models with Laboratory Findings
Jinyoung Kim, Han-Sang Baek, Jeonghoon Ha, Mee Kyoung Kim, Hyuk-Sang Kwon, Ki-Ho Song, Dong-Jun Lim, Ki-Hyun Baek
Diagnostics.2022; 12(6): 1468. CrossRef
The relationship between atherosclerotic disease and relapse during ATD treatment
Xinxin Zhu, Yaguang Zhang, Xiaoyu Zhao, Xiaona Zhang, Zixuan Ru, Yanmeizhi Wu, Xu Yang, Boyu Hou, Hong Qiao
Frontiers in Cardiovascular Medicine.2022;[Epub] CrossRef
Programmed Cell Death-Ligand 1 (PD-L1) gene Single Nucleotide Polymorphism in Graves’ Disease and Hashimoto’s Thyroiditis in Korean Patients
Jee Hee Yoon, Min-ho Shin, Hee Nam Kim, Wonsuk Choi, Ji Yong Park, A Ram Hong, Hee Kyung Kim, Ho-Cheol Kang
Endocrinology and Metabolism.2021; 36(3): 599. CrossRef
Low frequency of IL-10-producing B cells and high density of ILC2s contribute to the pathological process in Graves’ disease, which may be related to elevated-TRAb levels
Xiaoyun Ji, Jie Wan, Rong Chen, Huixuan Wang, Lan Huang, Shwngjun Wang, Zhaoliang Su, Huaxi Xu
Autoimmunity.2020; 53(2): 78. CrossRef
Implication of VDR rs7975232 and FCGR2A rs1801274 gene polymorphisms in the risk and the prognosis of autoimmune thyroid diseases in the Tunisian population
S Mestiri, I Zaaber, I Nasr, H Marmouch
Balkan Journal of Medical Genetics.2020; 23(1): 69. CrossRef
Thyroid Peroxidase Antibody Positivity is Associated With Relapse-Free Survival Following Antithyroid Drug Treatment for Graves Disease
Christopher A. Muir, Graham R.D. Jones, Jerry R. Greenfield, Andrew Weissberger, Katherine Samaras
Endocrine Practice.2020; 26(9): 1026. CrossRef
Predicting the Risk of Graves Disease Relapse: Commentary on “Thyroid Peroxidase Antibody Positivity is Associated with Relapse-Free Survival Following Antithyroid Drug Treatment for Graves Disease”
D. Gallo, M.L. Tanda, E. Piantanida
Endocrine Practice.2020; 26(9): 1039. CrossRef

Thyroid
The Biochemical Prognostic Factors of Subclinical Hypothyroidism: Myung Won Lee, Dong Yeob Shin, Kwang Joon Kim, Sena Hwang, Eun Jig Lee; Endocrinol Metab. 2014;29(2):154-162. Published online June 26, 2014; DOI: https://doi.org/10.3803/EnM.2014.29.2.154

3,623 View
50 Download
14 Web of Science
10 Crossref

Abstract PDF PubReader

Background

Patients with subclinical hypothyroidism (SHT) are common in clinical practice. However, the clinical significance of SHT, including prognosis, has not been established. Further clarifying SHT will be critical in devising a management plan and treatment guidelines for SHT patients. Thus, the aim of this study was to investigate the prognostic factors of SHT.

Methods

We reviewed the medical records of Korean patients who visited the endocrinology outpatient clinic of Severance Hospital from January 2008 to September 2012. Newly-diagnosed patients with SHT were selected and reviewed retrospectively. We compared two groups: the SHT maintenance group and the spontaneous improvement group.

Results

The SHT maintenance group and the spontaneous improvement group had initial thyroid-stimulating hormone (TSH) levels that were significantly different (P=0.035). In subanalysis for subjects with TSH levels between 5 to 10 µIU/mL, the spontaneous improvement group showed significantly lower antithyroid peroxidase antibody (anti-TPO-Ab) titer than the SHT maintenance group (P=0.039). Regarding lipid profiles, only triglyceride level, unlike total cholesterol and low density lipoprotein cholesterol, was related to TSH level, which is correlated with the severity of SHT. Diffuse thyroiditis on ultrasonography only contributed to the severity of SHT, not to the prognosis. High sensitivity C-reactive protein and urine iodine excretion, generally regarded as possible prognostic factors, did not show any significant relation with the prognosis and severity of SHT.

Conclusion

Only initial TSH level was a definite prognostic factor of SHT. TPO-Ab titer was also a helpful prognostic factor for SHT in cases with mildly elevated TSH. Other than TSH and TPO-Ab, we were unable to validate biochemical prognostic factors in this retrospective study for Korean SHT patients.

Citations

Citations to this article as recorded by

Determinants of Levothyroxine Treatment in Patients with Hypothyroidism
Savaş Karataş, Yalçın Hacıoğlu
Cyprus Journal of Medical Sciences.2022; 7(5): 593. CrossRef
Subclinical Hypothyroidism: Prevalence, Health Impact, and Treatment Landscape
Won Sang Yoo, Hyun Kyung Chung
Endocrinology and Metabolism.2021; 36(3): 500. CrossRef
Thyroid disorders in Brazil: the contribution of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)
I.M. Bensenor
Brazilian Journal of Medical and Biological Research.2019;[Epub] CrossRef
Risk factors for hypothyroidism in euthyroid thyroid nodule patients with lymphocytic thyroiditis on fine needle aspiration cytology
Jeong-Min Lee, Jeonghoon Ha, Kwanhoon Jo, Yejee Lim, Min-Hee Kim, Chan-Kwan Jung, So-Lyung Jung, Moo-Il Kang, Bong-Yun Cha, Dong-Jun Lim
The Korean Journal of Internal Medicine.2019; 34(6): 1287. CrossRef
Analysis of the factors affecting the evolution over time of subclinical hypothyroidism in children
Mariella Valenzise, Tommaso Aversa, Giuseppina Zirilli, Giuseppina Salzano, Domenico Corica, Simona Santucci, Filippo De Luca
Italian Journal of Pediatrics.2017;[Epub] CrossRef
Articles in 'Endocrinology and Metabolism' in 2014
Won-Young Lee
Endocrinology and Metabolism.2015; 30(1): 47. CrossRef
Reference interval for thyrotropin in a ultrasonography screened Korean population
Mijin Kim, Tae Yong Kim, Soo Han Kim, Yunkyoung Lee, Su-yeon Park, Hyung-don Kim, Hyemi Kwon, Yun Mi Choi, Eun Kyung Jang, Min Ji Jeon, Won Gu Kim, Young Kee Shong, Won Bae Kim
The Korean Journal of Internal Medicine.2015; 30(3): 335. CrossRef
Subclinical hypothyroidism: a historical view and shifting prevalence
J. V. Hennessey, R. Espaillat
International Journal of Clinical Practice.2015; 69(7): 771. CrossRef
Letter: The Biochemical Prognostic Factors of Subclinical Hypothyroidism (Endocrinol Metab2014;29:154-62, Myung Won Lee et al.)
Hwa Young Ahn, Yun Jae Chung
Endocrinology and Metabolism.2014; 29(3): 400. CrossRef
The Biochemical Prognostic Factors of Subclinical Hypothyroidism
You Jin Lee
Endocrinology and Metabolism.2014; 29(2): 144. CrossRef

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