Levels of Antithyroid Antiperoxidase and Antithyroglobulin Antibodies in Patients with Graves Hyperthyroidism – Predictors of Initial and Sustained Remission and Consecutive Hypothyroidism
, , y | 03 ene 2024
Publicado en línea: 03 ene 2024
Páginas: 83 - 86
Recibido: 22 jul 2023
Aceptado: 17 ago 2023
DOI: https://doi.org/10.3889/seejim.2023.6052
Palabras clave
© 2023 Natasha Stojkovska et al., published by Sciendo
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
BACKGROUND
Initial and sustained remission is the principal objective in patients with Graves hyperthyroidism (GH) treated with antithyroid drugs (ATD).
AIMS
Our study aimed to investigate the predictive value of antithyroid antiperoxidase (aTPO) and antithyroglobulin (aTg) levels on initial and sustained remission or consecutive hypothyroidism in subjects with GH treated with ATD.
METHODS
Randomized, prospective, and longitudinal study during period 2013–2018 was performed. Eighty GH patients (thyrotropin [TSH] <0.01 mIU/L, free thyroxine [FT4] >30 pmol/L, triiodothyronine [FT3] >8 pmol/L), 59 females (73.75%), and 21 males (26.25%), aged 51 ± 12 years were included in the study. Subjects were divided into four subgroups (each with 20 patients) according to aTPO and aTg levels: Group I – no antibodies; Group II – (<500 IU/mL), Group III – (500–1000 IU/mL), and Group IV – (>1000 IU/mL). All subjects underwent 24 months of propylthiouracil treatment with follow-up of 24 months after remission (TSH >0.4 mIU/L, FT4 11–25 pmol/L, FT3 2.8–6.5 pmol/L). Blood samples were analyzed every 4 months.
RESULTS
In Group I, 11 (55%) of the patients attained remission; during follow-up, 5 (45%) of them had disease relapse. In Group II, 12 (60%) attained remission and 5 (42%) had relapse. In Group III, 15 (75%) attained remission, 2 (13%) had disease relapse, and 4 (26%) developed hypothyroidism. In Group IV, 18 (90%) attained remission, 1 (5%) had disease relapse, and 9 (50%) developed hypothyroidism. Patients with values below 500 IU/mL attained remission in 60%, similar as the group without antibodies in 55% (p < 0.3). Patients in Group III and IV had significantly higher remission rates compared to Group I and II (p < 0.001). Baseline values of aTPO and aTg >1000 IU/mL were significant predictors of consecutive hypothyroidism (p < 0.05).
CONCLUSION
Baseline aTPO and aTg values above 500 IU/mL were significantly prognostic for attaining and sustaining remission in GH and values above 1000 IU/mL were significant predictors of consecutive hypothyroidism.