Are serum neopterin concentrations superior to other parameters in the differential diagnosis and prognostic assessment of Graves' disease?
There is a lack (1.) of a single criterion for the definitive differentiation between immunogenic (IH) and non-immunogenic hyperthyroidism (NIH), and (2.) also a lack of an unequivocal prognostic predictor for the individual course of patients with immunogenic hyperthyroidism. In 152 patients scheduled for iodine-131 therapy, serum neopterin concentrations were measured using a commercially available RIA, and the neopterin concentrations of IH (n = 84) and NIH (n = 42) patients were compared. Of these patients, 83 and 26 per cent respectively were treated with antithyroid drugs which did not have a significant impact on neopterin levels. In patients with IH and NIH, the concentrations [mean +/- SD] of neopterin were 1.89 +/- 0.79 milligrams and 1.98 +/- 0.9 milligrams, respectively (p = 0.4). After therapy with iodine-131, 28% of the IH-patients were euthyroid, 32% hyperthyroid, and 40% hypothyroid. In finally euthyroid patients, pretherapeutic neopterin concentrations were higher (3.1 +/- 2.8 milligrams) than in finally hyperthyroid (1.8 +/- 0.7 milligrams), or hypothyroid (1.6 +/- 0.7 milligrams) patients. These results argue against a relevant clinical role of neopterin concentrations for the differential diagnosis of IH versus NIH in these patients. However, a prognostic significance of neopterin concentrations in patients with IH is suggested.
Schomburg
A
A
Department of Nuclear Medicine, University of Bonn, Germany.
Grünwald
F
F
Schultes
B
B
Hotze
A
A
Bender
H
H
Biersack
H J
HJ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D001708:Biopterins / Q000031:analogs & derivatives* / Q000097:blood; D005260:Female; D006111:Graves Disease / Q000097:blood* / Q000175:diagnosis* / Q000532:radiotherapy; D006801:Humans; D006980:Hyperthyroidism / Q000097:blood* / Q000175:diagnosis* / Q000532:radiotherapy; D007457:Iodine Radioisotopes; D008297:Male; D008875:Middle Aged; D019798:Neopterin; D011237:Predictive Value of Tests; D011379:Prognosis; D011863:Radioimmunoassay; D013961:Thyroid Gland / Q000473:pathology
D015415:Biomarkers; D007457:Iodine Radioisotopes; D001708:Biopterins; D019798:Neopterin