Clinical characteristics of Graves' orbitopathy in patients showing discrepancy between levels from TBII assays and TSI bioassay
- Authors
- Jang, Sun Young; Shin, Dong Yeob; Lee, Eun Jig; Yoon, Jin Sook
- Issue Date
- Apr-2014
- Publisher
- Blackwell Publishing Inc.
- Citation
- Clinical Endocrinology, v.80, no.4, pp 591 - 597
- Pages
- 7
- Journal Title
- Clinical Endocrinology
- Volume
- 80
- Number
- 4
- Start Page
- 591
- End Page
- 597
- URI
- https://scholarworks.bwise.kr/sch/handle/2021.sw.sch/12301
- DOI
- 10.1111/cen.12318
- ISSN
- 0300-0664
1365-2265
- Abstract
- Objective To investigate clinical characteristics of patients with Graves' orbitopathy (GO) who showed discrepancies between levels of thyroid-stimulating immunoglobulin (TSI) and thyrotropin-binding inhibitory immunoglobulin (TBII). Design Comparative case series. Patients A total of 317 patients with GO in whom Mc4-TSI and M22-TRAb (third-generation TBII) were measured simultaneously. Patients were divided into four groups according to TRAb levels as followings: Group 1, TBII and TSI<median value; Group 2, TBII >= median, TSI<median; Group 3, TBII<median, TSI >= median; Group 4, both TBII and TSI >= median. Measurement Endocrine and ophthalmic clinical manifestations in each group. Results The median value of M22-TRAb was 6 center dot 11 IU/l and that of Mc4-TSI was 415 center dot 1 (SRR%). One hundred seventeen patients were classified as Group 1, 41 patients as Group 2, 41 patients as group 3 and 118 patients as group 4. Mean CAS was significantly higher in Groups 3 (2 center dot 2) and 4 (2 center dot 2) than in Groups 1 (1 center dot 6) and 2 (1 center dot 4; P=0 center dot 001, anova). Mean modified NOSPECS scores were significantly higher (P<0 center dot 001, anova) in Groups 3 (4 center dot 1) and 4 (4 center dot 1) than in Groups 1 (3 center dot 1) and 2 (2 center dot 3). The proportion of patients with hyperthyroidism was larger in Group 2 (85 center dot 4% [35/41 patients]) than in Group 3 (48 center dot 8% [20/41 patients]; P=0 center dot 002). Conclusions GO is more active and severe in patients with predominant Mc4-TSI than in patients with predominant M22-TRAb. Patients with hyperthyroidism were more likely to be included with patients with predominant M22-TRAb than with predominant Mc4-TSI.
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