Document Detail

Stimulation of thyroid-stimulating hormone (TSH) receptor antibody production following painless thyroiditis.
MedLine Citation:
PMID:  14678287     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: Development or recurrence of Graves' disease (GD) following painless thyroiditis (PT) has been documented. Therefore, we measured titres of TSH receptor antibodies (TSHR Ab) using a novel sensitive TSHR Ab assay in patients with PT to determine whether PT enhances TSHR Ab production, possibly triggering the development or recurrence of GD. DESIGN AND MEASUREMENTS: Ninety-two patients who developed PT were studied. Group G consisted of 40 patients with a history of GD (19 patients in remission, 21 who had stopped taking antithyroid drugs during pregnancy). Group P consisted of 52 patients with no history of GD. Serum thyroid hormone levels, thyroid autoantibodies including TSHR Ab, and 123I uptake at 24 h (RAIU) were measured in these patients at the time of PT onset. TSHR Abs were measured by radioreceptor assay using porcine TSH receptors (pTBII) or human TSH receptors (hTBII). RESULTS: There were no significant differences in serum thyroid hormone levels or pTBII values between groups G and P. Nor was there any significant difference between p- and h-TBII values in group P. There was also no significant difference in pTBII levels before, compared to at the time of PT onset in group G patients. However, hTBII values at the PT onset were significantly higher in the group G than in the group P (7.7 +/- 9.8%vs. 1.4 +/- 5.4%, P = 0.0014). The rate of hTBII positivity was also significantly higher in group G than in group P (12/40 vs. 3/52, P = 0.002). Furthermore, the RAIU in group G patients was significantly higher than that in group P patients (2.8 +/- 2.4%vs. 1.3 +/- 0.9%, P = 0.0002). GD recurrence was observed in seven patients in group G, whose hTBII levels were significantly higher than those of other patients in this group (17.0 +/- 11.8%vs. 5.7 +/- 8.2%, P = 0.02). Of these seven with relapses, five had hTBII values exceeding 15%. CONCLUSIONS: TBII elevation at the onset of PT in patients with a history of GD was detected by a sensitive hTBII assay. Destruction of the thyroid by PT may trigger GD recurrence in patients with a history of GD.
Makoto Iitaka; Nils G Morgenthaler; Naoko Momotani; Atsuo Nagata; Naofumi Ishikawa; Koichi Ito; Shigehiro Katayama; Kunihiko Ito
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Clinical endocrinology     Volume:  60     ISSN:  0300-0664     ISO Abbreviation:  Clin. Endocrinol. (Oxf)     Publication Date:  2004 Jan 
Date Detail:
Created Date:  2003-12-17     Completed Date:  2004-03-05     Revised Date:  2005-11-17    
Medline Journal Info:
Nlm Unique ID:  0346653     Medline TA:  Clin Endocrinol (Oxf)     Country:  England    
Other Details:
Languages:  eng     Pagination:  49-53     Citation Subset:  IM    
Department of Internal Medicine 4, Saitama Medical School, 38 Morohongo, Moroyama, Iruma-gun, Saitama, Japan.
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MeSH Terms
Autoantibodies / blood*
Graves Disease / immunology*
Iodine Radioisotopes / diagnostic use
Middle Aged
Receptors, Thyrotropin / blood,  immunology*
Statistics, Nonparametric
Thyroid Gland / metabolism
Thyroid Hormones / blood
Thyroiditis / immunology*
Reg. No./Substance:
0/Autoantibodies; 0/Iodine Radioisotopes; 0/Receptors, Thyrotropin; 0/Thyroid Hormones

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