K A Woeber1. 1. University of California San Francisco, Campus Box 1640, San Francisco, CA 94143-1640, USA. ken.woeber@ucsf.edu
Abstract
BACKGROUND AND AIM: In Graves' hyperthyroidism, suppression of serum TSH after restoration of normal serum T4 and T3 with treatment has been attributed to binding of TSH-receptor antibodies to TSH receptors in the pituitary. Accordingly, the relationship between TSH and serum thyroid stimulating immunoglobulin (TSI) was examined during follow-up of patients with Graves' hyperthyroidism. SUBJECTS AND METHODS: 23 patients with Graves' hyperthyroidism were identified who met the inclusion criteria of at least 24 months follow-up after initiation of methimazole and availability of concurrent measurements of serum TSH and TSI. RESULTS: TSI disappeared in 12 patients (Group A) and persisted in 11 patients (Group B). Initial T4 was not significantly different between the 2 groups. However, TSI was significantly lower in Group A than Group B [median (interquartile range) 179 (152-212)% vs 255 (208-369)%, p=0.0009]. In Group A, TSH normalized during treatment, and this anteceded disappearance of TSI by a significant time interval [median (interquartile range) 6 (3-8) months vs 15 (11-20) months, p=0.005]. In Group B, TSI persisted in all patients during follow-up ranging from 24 to 73 months. No correlation was found to exist between serum TSH and TSI, and for Group B TSI at final follow-up was not significantly different from the initial value [median (interquartile range) 255 (208-369)% vs 236 (160-310)%, p=0.4]. CONCLUSIONS: These findings do not support the suggestion that TSI has a direct suppressive effect on TSH secretion.
BACKGROUND AND AIM: In Graves' hyperthyroidism, suppression of serum TSH after restoration of normal serum T4 and T3 with treatment has been attributed to binding of TSH-receptor antibodies to TSH receptors in the pituitary. Accordingly, the relationship between TSH and serum thyroid stimulating immunoglobulin (TSI) was examined during follow-up of patients with Graves' hyperthyroidism. SUBJECTS AND METHODS: 23 patients with Graves' hyperthyroidism were identified who met the inclusion criteria of at least 24 months follow-up after initiation of methimazole and availability of concurrent measurements of serum TSH and TSI. RESULTS: TSI disappeared in 12 patients (Group A) and persisted in 11 patients (Group B). Initial T4 was not significantly different between the 2 groups. However, TSI was significantly lower in Group A than Group B [median (interquartile range) 179 (152-212)% vs 255 (208-369)%, p=0.0009]. In Group A, TSH normalized during treatment, and this anteceded disappearance of TSI by a significant time interval [median (interquartile range) 6 (3-8) months vs 15 (11-20) months, p=0.005]. In Group B, TSI persisted in all patients during follow-up ranging from 24 to 73 months. No correlation was found to exist between serum TSH and TSI, and for Group B TSI at final follow-up was not significantly different from the initial value [median (interquartile range) 255 (208-369)% vs 236 (160-310)%, p=0.4]. CONCLUSIONS: These findings do not support the suggestion that TSI has a direct suppressive effect on TSH secretion.
Authors: H Allannic; R Fauchet; J Orgiazzi; A M Madec; B Genetet; Y Lorcy; A M Le Guerrier; C Delambre; V Derennes Journal: J Clin Endocrinol Metab Date: 1990-03 Impact factor: 5.958
Authors: D Maugendre; A Gatel; L Campion; C Massart; I Guilhem; Y Lorcy; J Lescouarch; J Y Herry; H Allannic Journal: Clin Endocrinol (Oxf) Date: 1999-01 Impact factor: 3.478
Authors: R V García-Mayor; C Páramo; R Luna Cano; L F Pérez Mendez; J C Galofré; A Andrade Journal: J Endocrinol Invest Date: 1992-12 Impact factor: 4.256