Document Detail


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?
MedLine Citation:
PMID:  10390595     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
K Sugino; K Ito; O Ozaki; T Mimura; H Iwasaki; N Wada
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  World journal of surgery     Volume:  23     ISSN:  0364-2313     ISO Abbreviation:  World J Surg     Publication Date:  1999 Jul 
Date Detail:
Created Date:  1999-07-29     Completed Date:  1999-07-29     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  7704052     Medline TA:  World J Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  727-31     Citation Subset:  IM    
Affiliation:
Department of Surgery, Ito Hospital, 4-3-6 Jingumae, Shibuya-ku, Tokyo 150-8308, Japan.
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MeSH Terms
Descriptor/Qualifier:
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:
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

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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