No abstract available.
Receptors, Thyrotropin ; Thyrotropin

Antibodies* ; Receptors, Thyrotropin*

No abstract available.
Hypothyroidism* ; Immunoglobulin G* ; Receptors, Thyrotropin* ; Thyrotropin*

A study on the healthy voluntary adults without acute or chronic thyroid diseases, with ages of 21-48 who lived in Hanoi, Hai phong and HoChi Minh city has shown that there were no differences of total T3, T4 and FT3, FT4, TSH in the morning, noon and afternoon and there were no significant difference of these between men and women in each region and between regions.
Hormones ; Receptors, Thyrotropin ; Thyroid Hormones

GTP-Binding Proteins ; Receptors, Thyrotropin-Releasing Hormone ; Thyrotropin-Releasing Hormone*

The occurrence of Graves' disease following subacute thyroiditis (SAT) is rare. The pathophysiology of it is not well known. We report a case of Graves' disease following SAT presented with creeping. A 45-year-old woman presented with neck pain, and thyrotoxic symptoms. Neck pain migrated from left lobe to right lobe of the thyroid. Thyroid scan revealed decreased uptake in the both lobes except the superior portion of the right thyroid gland. Initially, the patient was diagnosed with SAT and treated with steroid therapy. Four months later, thyroid function test showed suppressed thyroid-stimulating hormone (TSH), elevated free thyroxine (T4) and TSH receptor antibody. Thyroid scan revealed increased uptake compatible with Graves' disease. The autoimmune alteration after SAT may lead to the development of Graves' disease in the susceptible patients. These patients should be monitored for the development of Graves' disease.
Female ; Graves Disease* ; Humans ; Middle Aged ; Neck Pain ; Receptors, Thyrotropin ; Thyroid Function Tests ; Thyroid Gland ; Thyroiditis, Subacute* ; Thyrotropin ; Thyroxine

Autoantibodies directed against the thyrotropin receptor have been well known to be an important pathogenesis of Graves' disease. However, the diagnosis and management of Graves' disease are still mainly dependent on thyroid function itself and clinical manifestation of thyrotoxic patients. That is mainly due to the low sensitivity of early generation of thyrotropin receptor assay methods. The development of sensitive thyrotropin receptor measuring tools through third generation immunometric assay made the diagnosis of Graves' disease with mild hyperthyroidism accurate and convenient for patients. Bioassay to detect thyroid stimulating immunoglobulin is also commercially available nowadays, which theoretically discriminate thyroid stimulating antibodies from thyrotropin receptor-blocking antibodies. Although the use of these serologic markers plays an informative role in accurately diagnosing Graves' disease and predicting the prognosis of disease, consideration of the heterogeneous nature of autoimmunity of Graves' disease and the limitation of indirect antibody assay is also required for proper management of Graves' disease patients. In this review, the clinical usefulness of thyrotropin receptor antibody in various clinical situations of Graves' disease was overviewed.
Antibodies ; Autoantibodies ; Autoimmunity ; Biological Assay ; Diagnosis ; Graves Disease ; Humans ; Hyperthyroidism ; Immunoglobulins, Thyroid-Stimulating ; Prognosis ; Receptors, Thyrotropin* ; Thyroid Gland ; Thyrotropin

BACKGROUND: It has been suggested that thyroid stimulation blocking antibody (TSBAb) is involved in the development of early hypothyroidism after radioiodine treatment in patient with Graves disease. However, previous studies have reported the effect of radioiodine treatment on overall changes of TSH receptor antibodies without detailed observation of changes in properties of TSH receptor antibodies. The aim of this study is to evaluate the effect of radioiodine treatment on thyroid stimulation antibody (TSAb) or on thyroid stimulation blocking antibody (TSBAb) activities and to see whether the appearance of TSBAb after radioiodine treatment is involved in the development of early hypothyroidism in patients with Graves disease. METHODS: The activities of TSAb, TSBAb were measured serially with human TSH receptor transfected Chinese hamster ovary (CHO) cells in 36 patients with Graves disease who received 131I treatment. In addition to the wild type TSH receptor-expressing cells, we used a chimeric receptor that 90-165 amino acid residues were substituted by those of rat LH/CG receptor (Mc2) for measurement of TSBAb without interference by the presence of TSAb and for evaluation of TSAb epitope spreading. We evaluated the association of early hypothyroidism after 131I treatment with changes of various immunologic parameters. RESULTS: In 14 (39%) of 36 patients, TSBAb activities were present in their sera before or after 131I treatment. Four of them had TSBAb activities before 131 treatment, and 12 newly acquired TSBAb activities after 131I treatment. The existence of TSBAb was not associated with the development of early hypothyroidism after 131I treatment but with low TSAb activities before 131 treatment, high thyroidal uptake of 131I given and with old age. The phenomena of epitope spreading measured by TSAb with Mc2 mutant clone before and after 131I treatment was not infrequent, but it had no clinical relevance. CONCLUSION: These results suggest that the existence of TSBAb may be not a major factor in the development of early hypothyroidism after radioiodine treatment in Graves disease. Other factors such as TSAb activities before radioiodine treatment, the efficiency of thyroidal uptake of 131I or old age are associated with the development of early hypothyroidism.
Animals ; Antibodies* ; Clone Cells ; Cricetinae ; Cricetulus ; Female ; Graves Disease* ; Humans ; Hypothyroidism ; Ovary ; Rats ; Receptors, Thyrotropin* ; Thyroid Gland ; Thyrotropin*

BACKGROUND AND OBJECTIVES: In the field of otolaryngology-head and neck surgery, surgical experience in hyperthyroidism is still limited with a lack of study on the subject. The author realized the necessity to study problems of early experience with the surgery. The purpose of this study is to elucidate significant prognostic factors in the surgery of Graves' disease and propose an optimum surgical method which is considered significant prognostic factors. SUBJECTS AND METHODS: Nineteen cases of Graves' disease and 4 cases of toxic nodule diagnosed and operated at the department of Endocrinology and department of Otolaryngology-Head and neck surgery of Kosin university Gospel Hospital, from November 1999 to February 2004 were retrospectively studied. To evaluate the safety of the surgery, preoperative management and postoperative complications were analyzed. The relations between postoperative thyroid function and surgical extent, lymphocytic infiltration, and TSH (Thyroid stimulating hormone) receptor binding inhibiting immunoglobulin were studied. Histological results of the postoperative thyroid tissue were also analyzed to detect any concurrent disease. RESULTS: Among the 9 cases of subtotal thyroidectomy in Graves' disease, 3 cases (33.3%) revealed postoperative hypothyrodism and 5 cases (55.6%) had normal thyroid function, while in 1 case (11.1%), hyperthyroidism recurred. There was no statistically significant relation between the degree of lymphocytic infiltration and postoperative thyroid function. Hyperthyroidism recurred 6 months postoperatively in one case with persistently elevated TSH receptor binding inhibiting immunoglobulin. No intraoperative or postoperative complication occurred in any of the cases. According to histopathologic results, 6 cases of Graves' disease were determined as diffuse thyroid hyperplasia and thyroid cancer was detected in 6 cases. CONCLUSION: This study revealed many advantages of surgical treatment in hyperthyroidism. High success rate and safe treatment without complication could be accomplished, and histologic diagnosis could be determined. Amounts of the remnant thyroid tissue and the level of TSH receptor binding inhibiting immunoglobulin seemed to be related to postoperative thyroid function. This study was performed with limited cases within a short period; thus, to preserve the remission state of postoperative thyroid function, studies on various factors affecting postoperative thyroid function are required.
Diagnosis ; Endocrinology ; Graves Disease ; Hyperplasia ; Hyperthyroidism* ; Immunoglobulins ; Neck ; Postoperative Complications ; Receptors, Thyrotropin ; Retrospective Studies ; Thyroid Gland ; Thyroid Neoplasms ; Thyroidectomy ; Thyrotropin

BACKGROUND: Graves' disease (GD) is an autoimmune thyroid disorder caused by antibodies stimulating the thyrotropin (TSH) receptor. TSH receptor antibody (TRAb) measurement is useful for predicting GD relapse after antithyroid drug (ATD) treatment. However, the association of other thyroid autoantibodies with GD relapse remains obscure. METHODS: This retrospective study enrolled patients with GD who were initially treated with ATD. TRAb, thyroid peroxidase antibody (TPOAb), and thyroglobulin antibody (TgAb) were measured at the initial diagnosis and at the time of ATD discontinuation. RESULTS: A total of 55 patients were enrolled. The mean age was 49.7 years, and 39 patients (70.9%) were female. Antibody positivity at diagnosis was 90.9%, 69.1%, and 61.9% for TRAb, TPOAb, TgAb, respectively. Median ATD treatment period was 15.1 months. At the time of ATD withdrawal, TRAb titers decreased uniformly overall. Conversely, TPOAb and TgAb showed various changes. After withdrawal of ATD, 19 patients (34.5%) experienced relapse. No clinical features or laboratory results were significantly related to relapse in the overall patient group. However, in the TPOAb positive group at diagnosis, increasing titer of TPOAb or TgAb after ATD treatment was significantly and independently related to relapse free survival (TPOAb: hazard ratio [HR], 17.99; 95% confidence interval [CI], 1.66 to 195.43; P=0.02) (TgAb: HR, 5.73; 95% CI, 1.21 to 27.26; P=0.03). CONCLUSION: Changes in TPOAb or TgAb titers during treatment might be useful for predicting relapse after ATD treatment in patients with positive TPOAb at diagnosis.
Antibodies ; Autoantibodies ; Diagnosis ; Drug Therapy ; Female ; Graves Disease ; Humans ; Iodide Peroxidase ; Receptors, Thyrotropin ; Recurrence ; Retrospective Studies ; Thyroglobulin ; Thyroid Gland ; Thyrotropin