[Clinical relevance of the determination of TSH-binding inhibitory immunoglobulins (TBII) in patients with immunogenic hyperthyroidism in methimazole therapy].

H J Heberling, B Bierwolf, E Kuhlmann, T Klugmann, P Dietel, S Fischer
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Abstract

In 38 patients with immunogenic hyperthyroidism a follow-up was performed to estimate the value of TBII before, during and after methimazole therapy. Before therapy increased TBII were detectable in 37 patients (94.4%). After 12 months methimazole therapy 25 patients had TSH-receptor antibodies (66%) within the normal range. In 13 patients positive antibody titres were found. In most cases persistence of increased TBII-values during drug treatment was an indicator of the persistence of active hyperthyroidism (10 of 13 patients). In the rule a disappearance of TBII-activity was combined with a functional remission (22 of 25 patients). Prolonged demonstration of TBII-activity in conjunction with persistence of hyperthyroidism should lead to ablative measures. In contrast to this medical therapy should be finished in patients with immunological and functional remission. Though in the further follow-up a recurrence of the immunological base of the disease with a functional and clinical relapse is possible.

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[甲巯咪唑治疗免疫原性甲亢患者tsh结合抑制性免疫球蛋白(TBII)测定的临床意义]。
对38例免疫原性甲状腺功能亢进症患者进行随访,以评估甲巯咪唑治疗前、期间和之后的TBII值。治疗前,37例患者(94.4%)检测到TBII升高。甲巯咪唑治疗12个月后,25例患者tsh受体抗体(66%)在正常范围内。13例患者抗体滴度均为阳性。在大多数病例中,药物治疗期间持续升高的tbii值是活动性甲亢持续存在的一个指标(13例患者中有10例)。在规则中,tbii活性消失与功能缓解相结合(25例患者中有22例)。长时间的tbii活动与持续的甲状腺功能亢进应该导致消融措施。与此相反,药物治疗应在免疫和功能缓解的患者中结束。虽然在进一步的随访中,疾病的免疫基础复发与功能和临床复发是可能的。
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