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The clinical and imaging data of 99 patients with Graves′ disease, 78 patients with thyroiditis and 28 patients with other diseases (resolving thyroiditis, non thyroid disease and simple goiter) who underwent thyroid scintigraphy in Beijing Shijingshan Hospital from January 2016 to March 2022 were retrospectively reviewed. The UR value of thyroid scintigraphy was calculated and ROC curve was used to assess the UR value in diagnosis of Graves′ disease. The UR value of patients with Graves′ hyperthyroidism was significantly higher than that of patients with thyroiditis and other diseases ( H=163.62, P<0.05). UR>4.84 was taken as optimal cutoff value to diagnose Graves′ hyperthyroidism, with the sensitivity and specificity of 95.0% and 98.1%, respectively.
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Objective: To observe the therapeutic effect of Xiakucao Oral Liquid combined with 131I on Graves disease and its effect on antibodies. Methods: The efficacy of 96 patients with Graves disease treated with Xiakucao Oral Liquid and 131I (observation group) was compared with those only treated with 131I (control group). The levels of TRAb, TGAb, and TPOAb were compared between the two groups before and after treatment. Results: The efficacy after 6 months of treatment between the observation group and the control group was statistically different (P 0.05). The TRAb level in the observation group decreased significantly after 6 months, and the difference between two groups was statistically significant (P < 0.01). The levels of TGAb and TPOAb increased in the two groups after 6 months of treatment, especially in the control group, and the differences were statistically significant (P < 0.05). Conclusion: Xiakucao Oral Liquid combined with 131I can effectively reduce the levels of serum TRAb, TGAb, and TPOAb in patients with Graves disease, and the efficacy of Xiakucao Oral Liquid combined with 131I is significantly better than 131I treatment only.
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Hashitoxicosis patients have the clinical characteristics of Graves' disease with hyperthyroidism and the pathological phenotype of Hashitoxicosis. The initial stage of hyperthyroidism is almost indistinguishable from Graves' disease in clinical manifestations, including increased uptake of radioactive iodine in the thyroid and positive antibodies to thyrotropin receptors, as well as high levels of thyroid peroxidase antibodies and/or thyroglobulin antibodies. Generally, the symptoms of hyperthyroidism are relatively mild, and the stage of hyperthyroidism is relatively short. Hashitoxicosis patients are sensitive to antithyroid drugs and are prone to hypothyroidism in the course of treatment. It will develop into permanent hypothyroidism after 3-24 months. Therefore, antithyroid drugs should be started at low doses, thyroid function should be detected frequently, and timely drug adjustment should be made.Radioactive iodine or surgical treatment should be avoided.
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Objective Using recombinant TrxTSHRc protein which contains TSBAb antigen epitope as antigen, an enzyme linked immunosorbent assay (ELISA) was established. The cut-off of positive values of TSH receptor antibody (TRAb) was established. Methods Using recombinant TrxTSHRc protein as antigen, the optimum condition was determined, and the indirect ELISA for detecting TRAb (TRAb-C) in the serum of normal control subjects and thyroid disease patients was established. A total of 1 085 patients and healthy controls were tested for this antibody. Results TRAb-C ELISA mainly detected TSBAb. The A405((-x)±s) value in healthy group was 0. 319±0. 107 with a cut-off value ((-x)±2 s)of 0. 533. The positive rate in thyroid disease patients showed significant deviation, with 66. 01 % in patients with Hashimoto's thyroiditis, 41.68% in newly-diagnosed Graves'disease, 6.98% in simple goiter, 11.1% in subacute thyroiditis, 8.7% in nontoxic thyroid nodular goiter, and 3.2% in thyroid adenoma. Conclusion The TRAb-C ELISA mainly detects TSBAb, which is very valuable for autoimmune thyroid disease, especially for the diagnosis, prognosis and therapy evaluation in Hashimoto' s thyroiditis.
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Objective:To investigate the association of thyrotropin receptor antibodies(TRAb) with the sensitivity to glucocorticoid therapy in Graves′s ophthalmopathy(GO) patients.Methods:Total 37 subjects with active GO were treated with prednisone. According to the relieve degree and clinical activity of their eye symptoms post-steroid treatment, patients were grouped into sensitive group(S) and non-sensitive group(NS). TRAb positive rate and antibody titer of the two groups were compared.Results:In S group( n=28 ), the positive rate and titre of TRAb were 76.53% and (12.54?5.62) U/L, respectively; The positive rate and titre of TRAb post-treatment were 22.18% and (7.82?4.91) U/L, respectively, were significant lower than data prior treatment. In NS group( n=9 ), the positive rate and titre of TRAb prior treatment were 67.24% and (11.07?4.63) U/L, respectively; The positive rate and titre of TRAb post-treatment were 59.74% and (10.81?5.96) U/L, there was no significant difference with data prior treatment. Prior treatment, there was no significant difference of TRAb titres between the two groups. Post-treatment, TRAb titres in NS group were significant higher than in S group.Conclusion:The variations of TRAb level were closely correlated with the sensitivity to glucocorticoid therapy in GO patients. Serum TRAb level can be used as a major index to evaluate therapeutic sensitivity to glucocorticoid therapy in GO.
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Objective:To study the value of measurement of serum TRAb levels in diagnosis and treatment of patients with thyroid disease.Methods:The levels of serum TRAb(by RRA),FT 3?FT 4 and titrations of TGAb,TPOAb(by RIA) were measured in 308 patients with thyroid disease as well as in 50 normal people.Results:The average levels and positive rates of serum TRAb were significantly higher in patients with Graves' disease (including hypertyroid group and remission group) and Hashimoto's disease than those in normal group,and the hypertyroid group were significant higher than the remission group in level and positive rate of TRAb.There were no correlations between serum TRAb levels and FT3,FT4 levels in patients with Graves' disease,and titrations of TGAb,TPOAb in patients with Hashimoto's disease.Conclusion:Serum TRAb level can not reflect the severity of Graves' disease,and TRAb is another auto-antibody different from TGAb,TPOAb,but there is important value in determing the serum TRAb level in diagnosis and treatment of auto-immune thyoid disease,especially to Graves' disease.
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One hundred and fifty-seven cases of Graves' disease were divided into three groups according to their clinical features and thyroid functions: Group A, untreated; group B, treated but uncontrolled or relapsed; group C, treated and remitted. The positive rates of TSH receptor antibody (TRAb), anti-tnyroglobulin antibody (TgAb), anti-microsomal antibody (TmAb), anti-DNA antibody and anti-nuclear antibody (ANA) were 91.2, 79.4, 79.4, 70.6 and 23.5% respectively in group A. The positive rate of TRAb and TBII were significantly different between group C and group A or B (both P
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In this paper the investigation of using a new method-ABC-ELISA in assay of Autoimmune Thyroid Disease are presented. The sensitivity of ABC-ELISA is compared with that of standard ELISA; Its reliability is proven by the methods of detecting TSAb with FRTL-5. TRAb is detected by ABC-ELISA in 91% of untreated Graves'. TRAb is detected by Standard ELISA in 70% of untreated Graves'. The results of ABC-ELISA in 26 untreated Graves' are equal to that of the method of detecting TSAb with FRTL-5. Therefore, we consider that ABC-ELISA is a sensitive, reproducible, convenient method applicable to clinical practice.