Thyrotropin receptor antibodies in parotid saliva.

Parotid saliva was collected with a Carlson-Crittenden device, under citric acid stimulation, in 18 patients with autoimmune thyroid disease. Thyrotropin Receptor Antibodies (TRAb) were measured with a radioreceptor assay in parotid saliva and in serum in the same patients, and a statistical analysis of the data was performed. TRAb levels in parotid saliva were higher than in serum in the 3 pathologies studied (Graves' disease, Hashitoxicosis and Hashimoto's thyroiditis). There was good correlation between salivary and serum levels.

[TSH receptor antibodies as a recurrence index of Graves disease treated with antithyroid drugs]. / Anticuerpos anti-receptor de TSH como índice de recidiva en la enfermedad de Graves tratada con drogas antitiroideas.

TSH receptor antibodies (TRAb) measured by the TBI residual assay (TBIr) were studied in 3 groups of Graves disease patients, as follows: 54 non treated cases (Group 1), 20 cases under methimazol treatment (Group 2) and 23 patients who were euthyroid after one year of methimazol treatment (Group 3), in order to evaluate the usefulness of TBIr as a recurrence index in Graves disease following antithyroid drug treatment. In group 1, TBIr was positive in 77.7% (45/54) of the cases. In group 2: 45% (9/20) had positive values for TBIr, all of which had a recurrence of disease during the year following the suppression of the treatment. In group 3, 69.5% patients (16/23) were TBIr positive. In 75% (12/16) of them the abnormally high values of TBIr predicted the recurrence, while 71.43% (5/7) of the patients, TBIr negatives, continued the remission 12 months later. By comparing the TBIr values before and after treatment in the group 3 patients, different possibilities were observed: a) TBIr persistently elevated: 52.17% (12/23). The 83.3% (10/12) had a recurrence before 6 months following treatment termination. b) TBIr, initially elevated, but later showing 50% decrease or negative values: 26.09% (6/23). Every patient was euthyroid one year after the treatment ended. c) TBIr persistently negative: 13.04% (3/23). Two of them had recurrence of their disease. d) TBIr negative which changed later to positive: 8.70% (2/23). Both presented a recurrence. In accordance with these results, we believe that abnormally high TBIr values before or after treatment is a useful recurrence index.(ABSTRACT TRUNCATED AT 250 WORDS)

Anticuerpos anti-receptor de TSH como índice de recidiva en la enfermedad de Graves tratada con drogas antitiroideas. / [TSH receptor antibodies as a recurrence index of Graves disease treated with antithyroid drugs]

TSH receptor antibodies (TRAb) measured by the TBI residual assay (TBIr) were studied in 3 groups of Graves disease patients, as follows: 54 non treated cases (Group 1), 20 cases under methimazol treatment (Group 2) and 23 patients who were euthyroid after one year of methimazol treatment (Group 3), in order to evaluate the usefulness of TBIr as a recurrence index in Graves disease following antithyroid drug treatment. In group 1, TBIr was positive in 77.7

(45/54) of the cases. In group 2: 45

(9/20) had positive values for TBIr, all of which had a recurrence of disease during the year following the suppression of the treatment. In group 3, 69.5

patients (16/23) were TBIr positive. In 75

(12/16) of them the abnormally high values of TBIr predicted the recurrence, while 71.43

(5/7) of the patients, TBIr negatives, continued the remission 12 months later. By comparing the TBIr values before and after treatment in the group 3 patients, different possibilities were observed: a) TBIr persistently elevated: 52.17

(12/23). The 83.3

(10/12) had a recurrence before 6 months following treatment termination. b) TBIr, initially elevated, but later showing 50

decrease or negative values: 26.09

(6/23). Every patient was euthyroid one year after the treatment ended. c) TBIr persistently negative: 13.04

(3/23). Two of them had recurrence of their disease. d) TBIr negative which changed later to positive: 8.70

(2/23). Both presented a recurrence. In accordance with these results, we believe that abnormally high TBIr values before or after treatment is a useful recurrence index.(ABSTRACT TRUNCATED AT 250 WORDS)

Thyroid glands in patients with Graves' disease are sources of thyrotropin-binding inhibitory (TBI) activity.

In order to investigate the main sources of production of Graves' immunoglobulins, 4 women with Graves' hyperthyroidism, which relapsed after withdrawal of methimazole (MMI) therapy, were selected for this study. The patients underwent subtotal thyroidectomy after pre-operative treatment with MMI and Lugol's solution. Seven blood samples were obtained in each patient during surgery from: a peripheral vein, immediately before neck incision; the carotid artery; and the left and right inferior thyroid veins, respectively, before manipulation of the thyroid; and the left and right inferior thyroid veins, respectively, after surgical handling of the gland; a peripheral vein at the end of operation. Thyrotropin-binding inhibitory (TBI) activity was measured in all samples by a radioligand method. Serum TSH was also measured in those samples. There was a substantial increment of TBI in the thyroid veins compared with the activity in the carotid artery. The mean TBI was significantly higher after surgical handling of the thyroid lobes. The two lobes from each gland secreted differing levels of TBI, whereas the TSH concentrations were similar in all samples from each individual patients. We conclude that at least part of the TBI activity in patients with Graves' disease comes from the lymphocytic infiltration of the glands, and that differences in antibody production between the thyroid lobes may explain the difference in TBI activity in their respective thyroid veins.