[Thyrotropin receptor antibodies (TRAb) as a test of surgical treatment effectiveness in Graves-Basedow's diseases].
The aim of the study was to assess the relations between the concentration of antibodies against TSH receptors (TRAb) and the outcome of the surgical treatment in Graves-Basedow's disease. The studies were performed in 30 patients (age range--18-50, mean -37) operated on for Graves-Basedow's disease and in 20 healthy controls. In control group, the TRAb concentration was mean -2.75 +/- 2.06 U/l, the TSH mean -1.06 +/- 0.53 mlU/l, and FT4 mean -14.71 +/- 2.15 pmol/l. The thyroid volume was mean -14.45 +/- 2.37 ml. In the group operated on antibody concentration was determined before and 12 months after the surgery. The TSH and FT4 concentrations were also determined before and 12 months after the operation. Moreover, the size of the thyroid remnant was assessed ultrasonographically 12 months after the procedure. The results showed the effectiveness of the surgical treatment, i.e. hyperthyroidism was not observed in 22 out of 30 patients. Among these 22 patients, euthyreosis was found in 14 cases (46%) and hypothyreosis was observed in 8 cases (27%). In the euthyreosis group, the pre-operative TRAb concentration was mean -24.00 +/- 11.04 U/l. 12 months after the operation, the decreased levels of antibodies were found in 13 patients (mean -6.14 +/- 5.71 U/l). In the hypothyreosis group, the pre-operative TRAb concentration was mean -24.50 +/- 10.43 U/l. After the surgical procedure, TRAb levels were normal in all patients, the average values being 2.13 +/- 1.34 U/l. In 8 patients with recurrent hyperthyroidism (27%), TRAb concentration before the surgery was higher, mean -107.25 +/- 56.69 U/l. 12 months after subtotal strumectomy, the patients in this group still did not show normal TRAb levels (mean -54.25 +/- 51.61 U/l). Moreover, the relations between the size of the thyroid remnant and the TRAb level were evaluated. In the group with recurrent hyperthyroidism and high TRAb levels, the thyroid size (volume) left was mean -12.10 +/- 6.25 ml, in the euthyreosis group mean -5.54 +/- 2.23 ml, while in the hypothyreosis group it was mean -4.86 +/- 1.14 ml.
Bojarska-Szmygin
Anna
A
Pracownia Medycyny Nuklearnej, Oddział Chirurgii Ogólnej, Zakład Diagnostyki Radiologicznej Wojewódzkiego Szpitala Specjalistycznego im. Kardynała Stefana Wyszyńskiego w Lublinie.
Ciechanek
Roman
R
Jezierska
Beata
B
Zaorska-Rajca
Janina
J
D000328:Adult; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D005260:Female; D006111:Graves Disease / Q000276:immunology* / Q000601:surgery*; D006801:Humans; D018828:Immunoglobulins, Thyroid-Stimulating / Q000097:blood*; D008297:Male; D008875:Middle Aged; D011989:Receptors, Thyrotropin / Q000276:immunology*; D012307:Risk Factors; D012680:Sensitivity and Specificity; D012737:Sex Factors; D013965:Thyroidectomy; D016896:Treatment Outcome
D015415:Biomarkers; D018828:Immunoglobulins, Thyroid-Stimulating; D011989:Receptors, Thyrotropin