Shibayama Keiko, Ohyama Yoshihide, Yokota Yukifumi, Ohtsu Shigeyuki, Takubo Noriyuki, Matsuura Nobuo
Department of Pediatrics, Kitasato University School of Medicine, Kanagawa, Japan.
Endocr J. 2005 Oct;52(5):505-10. doi: 10.1507/endocrj.52.505.
Studies on thyrotropin receptor autoantibodies (TRAb) by measurement of both thyroid-stimulating antibodies (TSAb) and thyrotropin-binding inhibitory immunoglobulins (TBII) in serum from children with Graves' disease are limited in number of studies. The aim of this study was to investigate the levels of serum TSAb and TBII in children with Graves' disease, and to evaluate the clinical significance of these antibodies. We measured the serum TSAb and TBII at diagnosis and during management in 65 children with Graves' disease. Patients were divided into four groups according to their metabolic state: those with untreated active Graves' disease, those receiving treatment with antithyroid drugs, those in remission, and those in relapse. At diagnosis, both TSAb and TBII assays had high sensitivities and high specificities. In follow-up, the levels of both TSAb and TBII paralleled the course of the disease. There was a strong positive correlation between TSAb and TBII. TBII levels were significantly higher in the patients with ophthalmopathy than those without ophthalmopathy in untreated Graves' children. It was concluded that TSAb and TBII measurements are valuable in the diagnosis and management of children with Graves' disease.
通过检测格雷夫斯病患儿血清中的甲状腺刺激抗体(TSAb)和促甲状腺激素结合抑制性免疫球蛋白(TBII)来研究促甲状腺激素受体自身抗体(TRAb)的研究数量有限。本研究的目的是调查格雷夫斯病患儿血清TSAb和TBII的水平,并评估这些抗体的临床意义。我们测量了65例格雷夫斯病患儿诊断时及治疗期间的血清TSAb和TBII。根据代谢状态将患者分为四组:未经治疗的活动性格雷夫斯病患者、接受抗甲状腺药物治疗的患者、缓解期患者和复发期患者。诊断时,TSAb和TBII检测均具有高敏感性和高特异性。在随访中,TSAb和TBII的水平与疾病进程平行。TSAb和TBII之间存在强正相关。在未经治疗的格雷夫斯病患儿中,有眼病的患者TBII水平明显高于无眼病的患者。得出的结论是,TSAb和TBII检测对格雷夫斯病患儿的诊断和治疗具有重要价值。