Prevalence of thyroid peroxidase, thyroglobulin and thyrotropin receptor antibodies in a long-term follow-up of juvenile Graves disease.
OBJECTIVE
To relate the presence of thyroid peroxidase antibodies (TPO ab), thyroglobulin antibodies (Tg ab) and thyrotropin receptor antibodies (TSH-R ab) to the clinical course in a long-term follow-up of patients with juvenile Graves' disease (JGD).


METHODS
Patients with JGD were drawn from a Danish retrospective study and reexamined.


RESULTS
A number of 105 patients were reexamined 4-21 years (median 10 years) after diagnosis. Three groups were formed: Gr.1: euthyroid patients with anti-thyroid drug (ATD) cessation more than 12 months before reexamination (n=41). Gr.2: patients still on ATD (n=24). Gr.3: subtotally thyroidectomized patients (n=40). Positive TPO ab titers were found in 75% of the patients. In 13% of the patients the titers were very high: >10,000 U/ml. Positive Tg ab were found in 51%. The prevalence of TPO ab and Tg ab was the lowest in group 3. Stimulating TSH-R ab titers were found in 13%. No patients had blocking TSH-R ab. The prevalence of TSH-R ab was 3% in the euthyroid patients, without surgery performed. 15% in the surgical patients, and 25% in the patients still on ATD.


CONCLUSIONS
Many JGD patients were euthyroid at the long-term follow-up in spite of high TPO ab and Tg ab titers. Stimulating TSH-R ab were rare (13%). According to this presence of TPO ab, Tg ab or TSH-R ab does not predict the final outcome of JGD. Further studies are needed.
Lavard
L
L
Department of Paediatrics, Hillerød Sygehus, Denmark.
Perrild
H
H
Jacobsen
B B
BB
Høier-Madsen
M
M
Bendinelli
G
G
Vitti
P
P
D000293:Adolescent; D000328:Adult; D001323:Autoantibodies / Q000097:blood*; D002648:Child; D003718:Denmark; D005260:Female; D005500:Follow-Up Studies; D006111:Graves Disease / Q000097:blood* / Q000188:drug therapy; D006801:Humans; D007453:Iodide Peroxidase / Q000276:immunology*; D008297:Male; D011989:Receptors, Thyrotropin / Q000276:immunology*; D012189:Retrospective Studies; D013954:Thyroglobulin / Q000276:immunology*
D001323:Autoantibodies; D011989:Receptors, Thyrotropin; D013954:Thyroglobulin; D007453:Iodide Peroxidase