ETA2024 Poster Presentations Autoimmunity (8 abstracts)
1Medical University in Bialystok, Department of Paediatric, Endocrinology and Diabetes, With A Cardiology Division. Medical University in Bialystok, Jerzego Waszyngtona 17 15-274 Białystok, Department of Paediatric, Endocrinology and Diabetes With A Cardiology Division, Białystok, Poland; 2Medical University in Bialystok, Poland, [email protected], Dep. of Pediatric Endocrinology and Diabetes With A Cardiology Unit., Białystok, Poland; 3Medical University in Bialystok, Department of Paediatric Endocrinology and Diabetes, With A Cardiology Division., Bialystok, Poland; 4Medical University in Bialystok., Department of Paediatric, Endocrinology and Diabetes With A Cardiology Division, Bialystok, Poland; 5Johannes Gutenberg University (Jgu) Medical Center, Johannes Gutenberg University Medical Center, Department of Medicine I, Molecular Thyroid Lab, Department of Medicine I, Mainz, Germany
Background: Thyrotropin receptor (TSH-R) stimulating autoantibodies (TSAb) are present in 95-99% of patients with Graves disease (GD). TSAb are functional, impact thyroid function, and are clinically relevant. This study we performed in pediatric patients with dynamic of Graves disease before and during methimazole therapy and in a patient with Hashimotos thyroiditis (HT) using a novel and ultra-rapid TSAb bioassay.
Methods: All samples from patients with autoimmune thyroid disease (AITD) and healthy controls were tested at the accredited and certified academic thyroid lab of the JGU Medical Center (Mainz, Germany) with a new TurboTM TSAb bioassay (Thyretain®, Quidel) with a readout that is based on a cyclic AMP-activated luciferase. The negative values for anti-thyroid receptor antibodies were: < 0,024 IU/l Results: Median age was 12 years (patients n = 80 / healthy controls n = 35; 12/10.5 years) and female: male ratio was 1,65. Of 80 samples, 43 (52.5%), 30 (36,5%) and 7 (11%) were hyperthyroid, hypothyroid and euthyroid respectively. The TSH-R-Ab assays were negative in 35 healthy controls devoid of autoimmune thyroid and endocrine disorders. Of 80, selected pediatric AITD patients (GD and HT), 41 were positive for TSAb. In the TurboTM cAMP TSAb assay was detected TSAb in 36 untreated GD patients (100%) and 5 treated by methimazole samples. The TurboTM TSAb bioassay highly correlated with thyroid function (P = 0.028). Three of 80 (3.75%) samples showed dual TSH-R-Ab positivity.
Conclusions: This is the largest reported collective of TSAb-positive samples in pediatric Graves disease, measured by a rapid and reliable TurboTM TSAb bioassay. TSAb markedly affects thyroid function. Furthermore, the novel TurboTM stimulating bioassay is clinically useful in the monitoring of pediatric Graves patients.
Key words: Graves disease, autoimmunity, TSAb, children