Endocrine Abstracts

Background:TAO is a progressive autoimmune potentially sight-threating disease. Various medical interventions have been reported which have potencially serious side effects.The high-dose intravenous immunoglobulin (IVIG) is known to have anti-inflammatory potential and it was used in pilot studies for patients with TAO. The aim of study : was to investigate the effect of IVIG on post-partum relapsed TAO and to test the some immunological parameters during and after therapy. Patients and Method: four patients with TAO had been treated before their pregnancy with bolus steroid and retroorbital irradiation therapy. Three month after delivery the eye symptomps relapsed and to avoid the side effects of steroids and irradiation we started the IVIG therapy. Schedule of IVIG:400 mg/kg/ day was given to 4 patients with TAO over 3-4 hr on four consecutive days.This therapeutic cycle was repeated one or more times depending on therapeutical results every 21 days.Duration of IVIG therapy was 3 months. Evaluated the therapy and monitored following laboratory data:clinical improvement was estimated by ATA (American Thyroid Association) standard criteria during the therapy. Orbital sonography or MRI was carried out for each patient.The following laboratory tests were made: IgG determination, anti-TSH receptor antibodies, determination of anti-thyroglobulin, anti-thyroid peroxidase, anti-eye muscle antibodies, measurement of neopterin-, soluble interleukin-2 receptor in the sera of patients before and during therapy. Results: The eye symptomps were ameliorated in three patients except N.4. Anti-TSH receptor-, anti-eye muscle antibodies and neopterin were significantly decreased after therapy. Substantial side effects were not found. It was concluded that IVIG therapy has a beneficial effect in severe types of post-partum relapsed TAO and decrease the autoimmune parameters which thought to be involved into pathomechanism. (Sponsored by OTKA T 037184/ 2002)