Christina Edelyn, Budiawan Hendra, Indrawati Hapsari, Affandi Soeriadi Erwin, Nugrahadi Trias, Kartamihardja A Hussein
Department of Nuclear Medicine, Padjadjaran University, Bandung, Indonesia.
Department of Nuclear Medicine, Mochtar Riady Comprehensive Cancer Center Siloam Hospital, Jakarta, Indonesia.
Asia Ocean J Nucl Med Biol. 2023;11(2):185-190. doi: 10.22038/AOJNMB.2023.68546.1478.
Graves' disease (GD) is the commonest cause of hyperthyroidism, accounted for 70-80% in iodine sufficient countries and up to 50% in iodine deficient countries. Combination of genetic predisposition and environmental factors influences the development of GD. Graves' orbitopathy (GO) represents the most common extra-thyroidal manifestation of GD with substantial impact on morbidity and quality of life. Expression of thyroid stimulating hormone receptor (TSHR) mRNA and protein in orbital tissues infiltrated by the activated lymphocytes produced by thyroid cells (Thyroid Receptor Antibody) results in the secretion of inflammatory cytokines that leads to the development of histological and clinical characteristics of GO. A subdivision of TRAb, thyroid stimulating antibody (TSAb), was found to have a close relationship with the activity and severity of GO, and suggested to be considered as a direct parameter of GO. Here, we present a 75-year-old female with a history of GD that has successfully been treated with radioiodine treatment, who developed GO 13 months after therapy while being hypothyroid with high TRAb level. The patient was given a second dose of radioiodine ablation to maintain GO with successful result.
格雷夫斯病（GD）是甲状腺功能亢进最常见的病因，在碘充足的国家占70 - 80%，在碘缺乏的国家高达50%。遗传易感性和环境因素共同影响GD的发生发展。格雷夫斯眼病（GO）是GD最常见的甲状腺外表现，对发病率和生活质量有重大影响。甲状腺细胞产生的活化淋巴细胞浸润的眼眶组织中促甲状腺激素受体（TSHR）mRNA和蛋白的表达导致炎性细胞因子的分泌，进而导致GO的组织学和临床特征的发展。促甲状腺素受体抗体（TRAb）的一个亚类，即甲状腺刺激抗体（TSAb），被发现与GO的活动和严重程度密切相关，并被建议作为GO的直接参数。在此，我们报告一名75岁女性，有GD病史，已成功接受放射性碘治疗，治疗13个月后出现GO，当时处于甲状腺功能减退状态且TRAb水平较高。该患者接受了第二剂放射性碘消融治疗以维持GO，结果成功。
