Characteristics of specific immunological indicators in patients with postoperative relapse of Graves’ disease
Background. Activity of autoimmune processes had a leading role in the development of relapse of hyperthyroidism. Level of thyroid-stimulating hormone (TSH) receptor antibodies is a basic factor that predetermines the relapse and can be used as a criterion to evaluate its development. A research aim was to study the structural and functional state of the thyroid gland, levels of thyroid peroxidase antibodies and TSH receptor antibodies in patients with postoperative relapse of Graves’ disease during antithyroid therapy. Materials and methods. The group of patients consisted of 25 women aged 23 to 73 years (an average of 53.56 ± 2.31 years). The period from the first surgical treatment to the development of relapse of thyrotoxicosis ranged from 1 to 29 years and averaged 13.33 ± 1.66 years. Results. It was found that the levels of TSH receptor antibodies, which are the main factors in the pathogenesis of Graves’ disease, are not decreased on the background of drug treatment that indicates a lack of perspective of conservative therapy for the post-operative relapse of this disease. Conclusions. When the state of medication compensation for thyrotoxicosis is achieved, it is recommended to conduct the therapy with I131 or surgical treatment of the relapse of Graves’ disease.
Full Text:PDF (Українська)
Cirocchi R, Trastulli S, Randolph J, et al. Total or near-total thyroidectomy versus subtotal thyroidectomy for multinodular non-toxic goitre in adults. Cochrane Database Syst Rev. 2015;(8):CD010370. doi: 10.1002/14651858.CD010370.pub2.
Stathopoulos P, Gangidi S, Kotrotsos G, Cunliffe D. Graves' disease: a review of surgical indications, management, and complications in a cohort of 59 patients. Int J Oral Maxillofac Surg. 2015 Jun;44(6):713-7. doi: 10.1016/j.ijom.2015.02.007.
Wilhelm SM, McHenry CR. Total thyroidectomy is superior to subtotal thyroidectomy for management of Graves' disease in the United States. World J Surg. 2010 Jun;34(6):1261-4. doi: 10.1007/s00268-009-0337-3.
Pankiv VI, ed. Syndrom tyreotoksykozu v klinichnij praktyci [Syndrome of thyrotoxicosis in clinical practice]. LAP LAMBERT Academic Publishing; 2017. 110 p. (in Ukrainian).
Bartalena L, Burch HB, Burman KD, Kahaly GJ. A 2013 European survey of clinical practice patterns in the management of Graves’ disease. Clin Endocrinol (Oxf). 2016 Jan;84(1):115-20. doi: 10.1111/cen.12688.
Villagelin D, Romaldini JH, Santos RB, Milkos ABBP, Ward LS. Outcomes in relapsed Graves’ disease patients following radioiodine or prolonged low dose of methimazole treatment. Thyroid. 2015 Dec;25(12):1282-90. doi: 10.1089/thy.2015.0195.
Stathopoulos P, Gangidi S, Kotrotsos G, Cunliffe D. Graves’ disease: a review of surgical indications, management, and complications in a cohort of 59 patients. Int J Oral Maxillofac Surg. 2015 Jun;44(6):713-7. doi: 10.1016/j.ijom.2015.02.007.
Opoku-Boateng A, Wang TS, Sosa IA. Thyroidectomy in patients with Graves’ disease. In: Graves' disease (Chapter). 2015. 99-113 pp.
Bojic T, Paunovic I, Diklic A, et al. Total thyroidectomy as a method of choice in the treatment of Graves' disease – analysis of 1432 patients. BMC Surg. 2015 Apr 9;15:39. doi: 10.1186/s12893-015-0023-3.
This work is licensed under a Creative Commons Attribution 4.0 International License.
© "Publishing House "Zaslavsky", 1997-2020