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Prediction of relapse in drug-treated Graves' disease using thyroid stimulation indices

1991; Oxford University Press; Volume: 125; Issue: 6 Linguagem: Inglês

10.1530/acta.0.1250643

1479-683X

Hiroshi Ikenoue, Ken Okamura, Kaori Sato, Takeo Kuroda, Mototaka Yoshinari, Takeshi Tokuyama, Mizuho Nakagawa, Masatoshi Fujishima,

Thyroid Cancer Diagnosis and Treatment

Thyroid stimulation indices such as high thyroidal radioactive iodine uptake, increased estimated thyroid weight, presence of TSH-binding inhibitor immunoglobulin or thyroid-stimulating antibody, and elevated serum thyroglobulin level, were evaluated in 148 patients with Graves' disease who had been treated with antithyroid drugs for two years or more before the drugs were withdrawn. In all 19 patients in whom three or more indices were positive, early relapse, within 12 months, occurred after reducing the dosage of antithyroid drugs. Other 129 patients were followed after the drug was withdrawn and in 77 patients with one or two positive indices, early relapse occurred in 65-71% and late relapse, after 12 months or later, occurred in 2-11%. In 52 patients in whom none of the indices were positive, 86% remained in remission, but 10% developed an early relapse, and 4% a late relapse. We conclude that a combined analysis of thyroid stimulation indices is useful in predicting relapse in Graves' disease whereas it remains difficult to predict permanent remission.