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학술저널
저자정보
권혜미 (울산대학교) 김원구 (울산대학교) 장은경 (울산대학교) 김미진 (울산대학교) 박수연 (울산대학교) 전민지 (서울아산병원) 김태용 (울산대학교) 류진숙 (울산대학교) 송영기 (울산대학교) 김원배 (울산대학교)
저널정보
대한내분비학회 Endocrinology and Metabolism Endocrinology and Metabolism Vol.31 No.2
발행연도
2016.1
수록면
300 - 310 (11page)

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Background: Hyperthyroidism relapse in Graves disease after antithyroid drug (ATD) withdrawal is common; however, measuringthe thyrotropin receptor antibody (TRAb) at ATD withdrawal in order to predict outcomes is controversial. This study comparedmeasurement of thyroid stimulatory antibody (TSAb) and thyrotropin-binding inhibitory immunoglobulin (TBII) at ATDwithdrawal to predict relapse. Methods: This retrospective study enrolled patients with Graves disease who were treated with ATDs and whose serum thyroidstimulatinghormone levels were normal after receiving low-dose ATDs. ATD therapy was stopped irrespective of TRAb positivityafter an additional 6 months of receiving the minimum dose of ATD therapy. Patients were followed using thyroid functiontests and TSAb (TSAb group; n=35) or TBII (TBII group; n=39) every 3 to 6 months for 2 years after ATD withdrawal. Results: Twenty-eight patients (38%) relapsed for a median follow-up of 21 months, and there were no differences in baseline clinicalcharacteristics between groups. In the TSAb group, relapse was more common in patients with positive TSAb at ATD withdrawal(67%) than patients with negative TSAb (17%; P=0.007). Relapse-free survival was shorter in TSAb-positive patients. In the TBIIgroup, there were no differences in the relapse rate and relapse-free survivals according to TBII positivity. For predicting Graves diseaserelapse, the sensitivity and specificity of TSAb were 63% and 83%, respectively, whereas those of TBII were 28% and 65%. Conclusion: TSAb at ATD withdrawal can predict the relapse of Graves hyperthyroidism, but TBII cannot. Measuring TSAb atATD withdrawal can assist with clinical decisions making for patients with Graves disease.

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