Endocrine Abstracts

Introduction: Graves’ hyperthyroidism is an autoimmune disease sustained by autoantibodies binding to and activating the TSH receptor located on the thyroid follicular cell. The objective of study was to determine the presence of anti-receptor TSH antibodies for the diagnosis of Grave’s diseases and the following up after surgery, iodine and treatment with antithyroid drug.

Results: In years 2006–2010 in our clinic in 265 patients for thyroid disorders 77.3% (205) were diagnosed with Grave’s diseases (154 female, 51 males with a ratio 3.01:1. Mean age was 44 years old±16.2 S.D.); 6% with multinodular toxic goiter; 4.3% with thyroiditis and 12.4% were euthyroid. All the patients were examined for the presence of anti-TSH receptor ab by RIA (Cisbio) and the cut off for positivity was >1.0 U/ml. The anti-rec-TSH ab antibodies were positive in 90.7% of patients with Graves’ disease before treatment with an average level 8.89 U/l±13.71 S.D. with a range 1.1–105, the antimicrosomal antibodies (M ab) were present in 76.5% and thyroglobulin antibodies (Tg ab) in 33%. In those without Graves’ disease, anti-rec-TSH ab were positive in 1.6%. In our study we found that anti-rec-TSH ab values before anti thyroid treatment had no any significance in predicting the remission of Graves’ disease after 1 and 2 years of anti thyroid drug therapy. In patients with positivity lowered down or became zero during the treatment the remission was very good, while the patient which remained with high level of anti-rec TSH ab the remission is not achieved and they remained hyperthyroid. No differences in patients treated with antithyroid drug and those treated with surgical intervention (total thyroidectomy): the positivity for anti-Rec TSH ab go down gradually in 50–60% of the cases they do remission with lower or disappeared antibodies. In the patients treated with radioiodine those with high titer of anti-rec TSH ab remain still positive after 1 or 2 years.

Conclusion: We conclude according our study that it is important to determine the anti receptor TSH antibodies for the diagnosis of Grave’s diseases and to predict the efficacy of the treatment.

Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.

Funding: This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.