Prevalence of Thyroid Peroxidase, Thyroglobulin and Thyrotropin Receptor Antibodies in a Long-Term Follow-Up of Juvenile Graves Disease

Abstract

Objective - To relate the presence of thyroid peroxidase antibodies (TPO ab), thyroglobulin antibodies (Tg ab) and thyrotropin receptor antibodies (TSH-R ab) to the clinical course in a long-term follow-up of patients with juvenile Graves'disease (JGD).

Design - Patients with JGD were drawn from a Danish retrospective study and reexamined. Results - A number of 105 patients were reexamined 4-21 years (median 10 years) after diagnosis. Three groups were formed; Gr. 1: euthyroid patients with anti-thyroid drug (ATD) cessation more than 12 months before reexamination (n=41). Gr.2: patients still on ATD (n=24). Gr.3: subtotally thyroidectomized patients (n=40). Positive TPO ab titers were found in 75% of the patients. In 13% of the patients the titers were very high: +10,000 U/ml. Positive Tg ab were found in 51 %. The prevalence of TPO ab and Tg ab was the lowest in group 3. Stimulating TSH-R ab titers were found in 13%. No patients had blocking TSH-R ab. The prevalence of TSH-R ab was 3% in the euthyroid patients, without surgery performed, 15% in the surgical patients, and 25% in the patients still on ATD.

Conclusions - Many JGD patients were euthyroid at the long-term follow-up in spite of high TPO ab and Tg ab titers. Stimulating TSH-R ab were rare (13%). According to this presence of TPO ab, Tg ab or TSH-R ab does not predict the final outcome of JGD. Further studies are needed

Key Words:

• Juvenile Graves disease
• Long-term follow-up
• Thyroid Peroxidase antibodies
• Thyroglobulin antibodies
• Stimulating and blocking thyrotropin receptor antibodies