Context: Thyroid stimulating immunoglobulin (TSI) and thyrotropin receptor antibody (TRAb) are specific biomarkers for Graves' disease (GD), but their clinical characteristics are not fully understood.
Objectives: To clarify the clinical features and prognostic significance of TSI and TRAb in patients with GD.
Design: A retrospective data analysis and a follow-up study.
Methods: Medical records of patients newly diagnosed with GD were examined. TSI and TRAb correlations were assessed using Passing-Bablok regression and Bland-Altman plot. Patients were categorized into unresolved (Group A) and resolved (Group B) hyperthyroidism based on thyroid function after one month of therapy. The relationship between thyroid function and changes in TRAb and TSI was analyzed. Logistic regression identified relapse risk factors, including TSI levels at antithyroid drugs (ATDs) withdrawal in the follow-up study.
Results: Data from 957 patients (762 female and 195 male) revealed a strong correlation between TRAb and TSI (r=0.873, p < 0.001). Compared to group B, group A showed minimal antibody decline [100% (interquartile range (IQR) 87.91%-115.1%) and 100% (IQR 85.03%-118.3%), respectively]. Among 206 patients followed for over 12 months after ATD discontinuation, the relapse rate was 41.26%. Relapse was more frequent in patients with positive TSI (54.84% vs. 35.42%, p < 0.05). Positive TSI levels at withdrawal, past history of GD, age and mild thyroid-associated ophthalmopathy were independent relapse predictors.
Conclusions: TSI and TRAb are strongly correlated in GD, with slow antibody decline linked to unresolved hyperthyroidism. Discontinuing ATDs may be considered when both TSI and TRAb are negative.
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http://dx.doi.org/10.1210/clinem/dgae892 | DOI Listing |
J Clin Endocrinol Metab
December 2024
Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Front Endocrinol (Lausanne)
December 2024
Endocrinology Department of Foshan Second People's Hospital, Foshan, China.
Introduction: TSH-receptor antibodies (TRAb) directed against the TSH receptor (TSH-R) induce hyperthyroidism in patients with Graves' disease (GD). TRAb detected by previous radioimmunoassay only reflects the presence of autoantibodies, but not the function of such antibodies. Thyroid stimulating immunoglobulins (TSI) is a relatively new method for assessing TSH-receptor antibodies function.
View Article and Find Full Text PDFClin Chem Lab Med
October 2024
Department of Clinical Biochemistry, 53141 Aalborg University Hospital, Aalborg, Denmark.
Objectives: Thyrotropin-receptor antibodies (TRAb) are used to diagnose Graves' hyperthyroidism in pregnant women. Bioassays provide a measure of thyrotropin-receptor stimulatory antibodies (TSI) specifically. The objective was to measure TSI in pregnant women for establishment of a pregnancy-specific cut-off and comparison with immunoassay measurements of TRAb.
View Article and Find Full Text PDFHeliyon
December 2023
Laboratory Medical Immunology, Department of Immunology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands.
Background: Graves' disease (GD) is caused by the production of TSH-receptor (TSHR) stimulating auto-antibodies. Over the years various TSHR-antibody (TRAb) detection assays have been developed. Most clinical laboratories use competitive TSH-binding inhibitory immunoglobulin (TBII) assays, which measure the total amount of stimulating and blocking auto-antibodies.
View Article and Find Full Text PDFAm J Ophthalmol
February 2024
From the Department of Ophthalmology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea (H.J.B., J.K., J.S.Y.). Electronic address:
Purpose: Rehabilitative orbital decompression treats disfiguring exophthalmos in patients with Graves' orbitopathy (GO). This study aimed to identify risk factors associated with the postoperative recurrence of proptosis after orbital decompression.
Design: Retrospective, case-control study.
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