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CC BY-NC-ND 4.0 · Exp Clin Endocrinol Diabetes 2023; 131(04): 236-241
DOI: 10.1055/a-2021-0596
Article

Comparison Between Thyroid Stimulating Immunoglobulin and TSH-Receptor Antibodies in the Management of Graves’ Orbitopathy

Selwan Khamisi
1   Department of Endocrinology and Diabetes, Uppsala University Hospital, Uppsala, Sweden
2   Department of Medical Sciences, Uppsala University, Uppsala, Sweden
,
Martin Lundqvist
1   Department of Endocrinology and Diabetes, Uppsala University Hospital, Uppsala, Sweden
2   Department of Medical Sciences, Uppsala University, Uppsala, Sweden
,
Britt Edén Engström
1   Department of Endocrinology and Diabetes, Uppsala University Hospital, Uppsala, Sweden
2   Department of Medical Sciences, Uppsala University, Uppsala, Sweden
,
Anders Larsson
2   Department of Medical Sciences, Uppsala University, Uppsala, Sweden
,
F Anders Karlsson
1   Department of Endocrinology and Diabetes, Uppsala University Hospital, Uppsala, Sweden
2   Department of Medical Sciences, Uppsala University, Uppsala, Sweden
,
Östen Ljunggren
1   Department of Endocrinology and Diabetes, Uppsala University Hospital, Uppsala, Sweden
2   Department of Medical Sciences, Uppsala University, Uppsala, Sweden
› Institutsangaben Funding Open Access funding was provided by Uppsala University. This work was supported by grants from the research of Uppsala University Hospital and the Faculty of Medical Science at Uppsala University.
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Abstract

Objectives TSH-receptor antibodies (TRAb) targeting the TSH receptor (TSH-R) induce hyperthyroidism in Graves´ disease (GD). Graves´ orbitopathy (GO) is influenced by stimulation of the TSH-R in the orbita. GO has been, among other factors, linked to high TRAb levels. Thyroid stimulating immunoglobulins (TSI) is a relatively new method for assessing TSH-receptor antibodies. The aim of this study was to investigate the role of TSI in the management of GO.

Methods Patients with newly diagnosed GD (n=30, median age 55 years (range 35–72), 29 women) received pharmacological therapy (methimazole+++thyroxine) for up to 24 months. GO was identified by clinical signs and symptoms. Eleven patients had GO at diagnosis, and another six developed GO during treatment. Blood samples for TSI and other thyroidal biomarkers were obtained at baseline and on five occasions during the 24-month follow-up. Twenty-two subjects completed the drug regimen without surgery or radioiodine treatment.

Results At baseline, TSI was highly correlated with TRAb (r s =0.64, p<0.001), and both assays similarly correlated to fT3 values. TSI and TRAb did not differ significantly between GO and non-GO patients for visit v1 (n=30, 17 GO during the whole study) or at follow-up (n=22, 12 GO during the whole study). During follow-up, levels of TSI and TRAb decreased and normalized in both groups.

Conclusion The present study does not support any added benefit of TSI compared to TRAb for the prediction and management of GO.

Key words

Graves` disease - TRAb - TSI


Publikationsverlauf

Eingereicht: 13. September 2022
Eingereicht: 22. Dezember 2022

Angenommen: 05. Januar 2023

Accepted Manuscript online:
27. Januar 2023

Artikel online veröffentlicht:
03. März 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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