| Postoperative changes in thyrotropin-binding inhibitory immunoglobulin level in patients with Graves' disease: is subtotal thyroidectomy a suitable therapeutic option for patients of childbearing age with Graves' disease? | |
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MedLine Citation:
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PMID: 10390595 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Thyroid-stimulating hormone (TSH)-binding inhibitory immunoglobulin (TBII) is thought to be one of the essential causes of Graves' disease, and most cases of neonatal hyperthyroidism can be explained by transplacental passage of TBII. Because surgery is often indicated for patients of childbearing age, it is important to elucidate how surgery reduces TBII levels. Between 1988 and 1991 a total of 946 female patients with Graves' disease underwent subtotal thyroidectomy. Follow-up examination was undertaken at 1, 2, 3, and 4 to 5 years after surgery. At 4 to 5 years after surgery, 76.8% of patients without recurrent overt hyperthyroidism had TBII < 20%. In patients with recurrent hyperthyroidism, TBII increased gradually during follow-up, and they had higher TBII levels than nonrecurrence patients. There were a few euthyroid and hypothyroid patients who had TBII > 60%, and the number of such patients decreased annually. In most of the patients, immunologic remission was obtained by subtotal thyroidectomy except for their having recurrent hyperthyroidism. To acquire immunologic remission, hormonal remission, at least, would be necessary. Because no definite factor other than the size of the thyroid remnant related to postoperative thyroid function was elucidated, near-total thyroidectomy rather than subtotal thyroidectomy is expected to be induced not only hormonal remission but also immunologic remission. It should be noted that a few patients achieved hormonal remission but not immunologic remission. |
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Authors:
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K Sugino; K Ito; O Ozaki; T Mimura; H Iwasaki; N Wada |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: World journal of surgery Volume: 23 ISSN: 0364-2313 ISO Abbreviation: World J Surg Publication Date: 1999 Jul |
Date Detail:
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Created Date: 1999-07-29 Completed Date: 1999-07-29 Revised Date: 2008-11-21 |
Medline Journal Info:
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Nlm Unique ID: 7704052 Medline TA: World J Surg Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 727-31 Citation Subset: IM |
Affiliation:
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Department of Surgery, Ito Hospital, 4-3-6 Jingumae, Shibuya-ku, Tokyo 150-8308, Japan. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Autoantibodies / blood* Female Follow-Up Studies Graves Disease / blood, immunology, surgery* Humans Hyperthyroidism / blood, etiology, immunology Hypothyroidism / blood, etiology, immunology Immunoglobulins, Thyroid-Stimulating Iodine Radioisotopes / diagnostic use Patient Care Planning Postoperative Complications Radiopharmaceuticals / diagnostic use Receptors, Thyrotropin / blood* Recurrence Retrospective Studies Thyroidectomy / methods* Thyronines / blood Thyrotropin / blood, diagnostic use Thyroxine / blood |
| Chemical | |
Reg. No./Substance:
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0/Autoantibodies; 0/Immunoglobulins, Thyroid-Stimulating; 0/Iodine Radioisotopes; 0/Radiopharmaceuticals; 0/Receptors, Thyrotropin; 0/Thyronines; 0/thyrotropin-binding inhibitory immunoglobulin; 7488-70-2/Thyroxine; 9002-71-5/Thyrotropin |
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