Selwan Khamisi, Martin Lundqvist, Britt Edén Engström, Anders Larsson, F Anders Karlsson, Östen Ljunggren
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引用次数: 0
Abstract
Objectives: TSH-receptor antibodies (TRAb) targeting the TSH receptor (TSH-R) induce hyperthyroidism in Graves´ disease (GD). Graves´ orbitopathy (GO) is influenced by stimulation of the TSH-R in the orbita. GO has been, among other factors, linked to high TRAb levels. Thyroid stimulating immunoglobulins (TSI) is a relatively new method for assessing TSH-receptor antibodies. The aim of this study was to investigate the role of TSI in the management of GO.
Methods: Patients with newly diagnosed GD (n=30, median age 55 years (range 35-72), 29 women) received pharmacological therapy (methimazole+++thyroxine) for up to 24 months. GO was identified by clinical signs and symptoms. Eleven patients had GO at diagnosis, and another six developed GO during treatment. Blood samples for TSI and other thyroidal biomarkers were obtained at baseline and on five occasions during the 24-month follow-up. Twenty-two subjects completed the drug regimen without surgery or radioiodine treatment.
Results: At baseline, TSI was highly correlated with TRAb (rs =0.64, p<0.001), and both assays similarly correlated to fT3 values. TSI and TRAb did not differ significantly between GO and non-GO patients for visit v1 (n=30, 17 GO during the whole study) or at follow-up (n=22, 12 GO during the whole study). During follow-up, levels of TSI and TRAb decreased and normalized in both groups.
Conclusion: The present study does not support any added benefit of TSI compared to TRAb for the prediction and management of GO.
目的:靶向TSH受体(TSH- r)的TSH受体抗体(TRAb)可诱导Graves病(GD)的甲状腺功能亢进。Graves眼窝病(GO)受眼眶TSH-R刺激的影响。除其他因素外,氧化石墨烯与高TRAb水平有关。促甲状腺免疫球蛋白(TSI)是一种较新的检测tsh受体抗体的方法。本研究的目的是探讨TSI在GO治疗中的作用。方法:新诊断的GD患者(n=30,中位年龄55岁(35-72岁),女性29例)接受药物治疗(甲巯咪唑+++甲状腺素),疗程长达24个月。通过临床体征和症状确定GO。11例患者在诊断时出现氧化石墨烯,另有6例患者在治疗期间出现氧化石墨烯。在24个月的随访期间,在基线和5次中获得TSI和其他甲状腺生物标志物的血液样本。22名受试者在没有手术或放射性碘治疗的情况下完成了药物治疗。结果:在基线时,TSI与TRAb高度相关(r s =0.64, p)。结论:本研究不支持TSI与TRAb相比在预测和管理GO方面有任何额外的益处。
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