Naslov
Thyroid peroxidase autoantibodies are associated with a lesser likelihood of late reversion to hyperthyroidism after successful non-ablative treatment of Graves' disease in Croatian patients

Autori
Štefanić, Mario ; Karner, Ivan

Izvornik
Journal of endocrinological investigation (0391-4097) 37 (2014), 1; 71-77

Vrsta, podvrsta i kategorija rada
Radovi u časopisima, članak, znanstveni

Ključne riječi
Thyroid peroxidase autoantibodies (TPOAbs) ; Graves' disease (GD) ; remission

Sažetak
Thyroid peroxidase autoantibodies (TPOAbs) are frequently observed in Graves' disease (GD) and tend to persist in patients even after successful treatment with antithyroid drugs. However, there is a lack of consistent data regarding the prognostic significance of TPOAbs during and after non-ablative treatment for Graves' hyperthyroidism.100 remitters were retrospectively investigated for factors associated with the 5-year course of disease recurrence and compared to 60 age/sex-matched patients with intractable GD. Mild hyperthyroidism, low baseline thyroid-stimulating antibodies levels, and small goiters were predictive of remission. Once attained, the remission was shorter in younger patients, patients with declining post-treatment TSH values, and negative baseline TPOAb levels. The 5-year cumulative incidence of relapse incrementally increased from 24 to 44 to 70% across decreasing TPOAb tertiles (log-rank, p=0.00056 ; the lower tertile representing TPOAb-negative cases). The age-of-onset (p=0.034), and the baseline TPOAb value [upper tertile, hazard ratio(HR) 0.25 ; 95 % confidence interval, 0.11-0.59 ; p=0.0014 ; middle tertile, HR 0.47 (0.24-0.9) ; p=0.024 ; Cox regression] were inversely associated with late(>12 months) relapse rates in a level-dependent manner. In contrast, serum logTSH measured 6 months after drug discontinuation was inversely associated with hazard rates at all time points (p=0.0005). Baseline TPOAb positivity is an independent indicator of long-term remission in GD patients who have been successfully treated, but the mechanism of action and causal relations remain unknown.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

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