title: Evidence of intrathyroidal accumulation of TSH receptor antibody in Graves' disease.
abstract: To clarify the intrathyroidal accumulation of TSH receptor antibody (TR-ab) produced in the thyroid, adrenalin was injected directly into the thyroid artery of patients with Graves' disease during surgery, allowing serial determination of the TR-ab levels in the thyroidal venous blood. Nine surgical patients (3M and 6F) with Graves' disease and receiving anti-thyroid drugs preoperatively for a period of one to four years were enrolled in this study. Comparison between pre- and posttreatment TR-ab levels revealed continuous increments from the pretreatment levels within 15 min of the injection in five (55.6%) of the nine patients. In three of the five patients, TR-ab levels that had been negative before adrenalin injection became positive 1 min after injection. It is assumed that the increase in the TR-ab level is due to adrenalin-induced constriction of the capillaries in the thyroid tissues, resulting in a voluminous flow of the TR-ab retained in the thyroid into the vein. These findings indicate that the TR-ab level in the peripheral blood does not necessarily reflect precisely the abnormal immunological condition in the Graves' thyroid.
authors.affiliation: Department of Surgery, Shinshu University School of Medicine, Matsumoto, Japan.
authors.forename: A
authors.initials: A
authors.lastname: Sugenoya
authors.forename: S
authors.initials: S
authors.lastname: Kobayashi
authors.forename: Y
authors.initials: Y
authors.lastname: Kasuga
authors.forename: H
authors.initials: H
authors.lastname: Masuda
authors.forename: M
authors.initials: M
authors.lastname: Fujimori
authors.forename: M
authors.initials: M
authors.lastname: Komatsu
authors.forename: S
authors.initials: S
authors.lastname: Takahashi
authors.forename: S
authors.initials: S
authors.lastname: Yokoyama
authors.forename: T
authors.initials: T
authors.lastname: Shimizu
authors.forename: T
authors.initials: T
authors.lastname: Yamada
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000906:Antibodies / Q000032:analysis*; D002319:Cardiovascular System / Q000187:drug effects; D004837:Epinephrine / Q000009:adverse effects / Q000494:pharmacology; D005260:Female; D006111:Graves Disease / Q000097:blood / Q000276:immunology* / Q000601:surgery; D006801:Humans; D007267:Injections; D007432:Intraoperative Period; D008297:Male; D008875:Middle Aged; D011989:Receptors, Thyrotropin / Q000276:immunology*; D013961:Thyroid Gland / Q000187:drug effects / Q000276:immunology*; D014680:Veins
chemical_list: D000906:Antibodies; D011989:Receptors, Thyrotropin; D004837:Epinephrine