Uno C, Nishikawa M
Second Division of Internal Medicine, Kansai Medical University, Osaka, Japan.
Nihon Naibunpi Gakkai Zasshi. 1988 Mar 20;64(3):206-15. doi: 10.1507/endocrine1927.64.3_206.
To evaluate the clinical significance of TBII and TSAb activities in euthyroid and hyperthyroid Graves' disease, these two activities were measured in 8 patients with euthyroid Graves' disease and 29 patients with hyperthyroid Graves' disease during treatment with antithyroid drugs. In 8 patients with euthyroid Graves' disease, TBII activity was detectable only in one patient and TSAb activity detected in 3 patients, these detectabilities being much lower than those in hyperthyroid Graves' disease. However, 2 of 4 patients who had either TSAb or TBII came to have both activities, and one of them became overt hyperthyroid. In patients with hyperthyroid Graves' disease, detectabilities of these activities became lower as they became euthyroid with antithyroid drug treatment, but TSAb tended to be higher than TBII when they remained euthyroid for more than 4 months. Although the majority of the patients who had TSAb and/or TBII activities were T3 non-suppressible, patients with no TSAb and TBII activities did not necessarily show remission of the disease. The present results suggest that patients with euthyroid Graves' disease with both TBII and TSAb may be apt to become hyperthyroid, and that TSAb and TBII activities and T3 suppressibility may not be a definite criteria for the remission of Graves' disease.
为评估甲状腺刺激阻断性抗体（TBII）和甲状腺刺激抗体（TSAb）活性在甲状腺功能正常和甲状腺功能亢进的格雷夫斯病中的临床意义，我们在8例甲状腺功能正常的格雷夫斯病患者和29例甲状腺功能亢进的格雷夫斯病患者接受抗甲状腺药物治疗期间测量了这两种活性。在8例甲状腺功能正常的格雷夫斯病患者中，仅1例可检测到TBII活性，3例可检测到TSAb活性，这些可检测性远低于甲状腺功能亢进的格雷夫斯病患者。然而，4例有TSAb或TBII的患者中有2例后来同时出现了这两种活性，其中1例发展为显性甲状腺功能亢进。在甲状腺功能亢进的格雷夫斯病患者中，随着抗甲状腺药物治疗使他们甲状腺功能恢复正常，这些活性的可检测性降低，但当他们甲状腺功能正常持续超过4个月时，TSAb往往高于TBII。虽然大多数有TSAb和/或TBII活性的患者T3不被抑制，但没有TSAb和TBII活性的患者不一定显示疾病缓解。目前的结果表明，同时具有TBII和TSAb的甲状腺功能正常的格雷夫斯病患者可能易于发展为甲状腺功能亢进，并且TSAb和TBII活性以及T3抑制性可能不是格雷夫斯病缓解的明确标准。
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