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대한안과학회 Korean Journal of Ophthalmology Korean Journal of Ophthalmology 제29권 제4호
발행연도
2015.1
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213 - 219 (7page)

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Purpose: To investigate associations between serum thyroid stimulating hormone (TSH) receptor antibody (TRAb) levels and Graves’ orbitopathy (GO) activity/severity in chronic-stage GO and compare the performance of two newly-developed TRAb assays (third-generation TSH-binding inhibition immunoglobulin [TBII] assay versus Mc4 thyroid-stimulating immunoglobulin [TSI] bioassay). Methods: This study is a retrospective review of medical charts and blood tests from Korean GO patients who first visited the departments of ophthalmology and endocrinology, Yonsei University College of Medicine from January 2008 to December 2011, were diagnosed with GO and Graves’ hyperthyroidism, and were followed up for ≥18 months. Third-generation M22-TBII and Mc4-TSI assays were performed in the chronic-inactive GO patients in whom euthyroidism status was restored. Patients’ GO activity/severity clinical activity scores (CAS), and modified NOSPECS scores were examined for a correlation with TRAb assays. Results: Fifty patients (mean age, 41.3 years; 41 females) were analyzed. The mean duration of Graves’ hyperthyroidism symptom was 63 months (range, 18 to 401 months) and that of GO was 46 months (range, 18 to 240 months). All patients had been treated previously with anti-thyroid drugs for a median period of 52.3 months, and two patients underwent either radioiodine therapy or total thyroidectomy. Mean CAS and NOSPECS scores were 0.5 ± 0.9 (standard deviation) and 4.8 ± 3.1, respectively. Mean M22-TBII and Mc4-TSI values were 7.5 ± 10.2 IL/L and 325.9 ± 210.1 specimen-to-reference control ratio. TSI was significantly correlated with NOSPECS score (R = 0.479, p < 0.001); however, TBII was not associated with NOSPECS score (p = 0.097). Neither TSI nor TBII correlated with CAS (p > 0.05), because GO inflammatory activity subsided in the chronic stages of GO. Conclusions: In chronic-inactive GO after euthyroid restoration, GO activity score did not associate with serum levels of TRAb or TBII. However, levels of the functional antibody Mc4-TSI did correlate with GO severity. Therefore, the TSI bioassay is a clinically relevant measure of disease severity even in chronic inactive GO.
#Biological assay #Chronic inactive Graves' orbitopathy #Mc4-TSI #Thyroid-stimulating immunoglobulin #Thyrotropin-binding inhibitory immunoglobulin

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참고문헌 (23)

참고문헌 신청
Bahn RS / 2010 / Graves’ ophthalmopathy / N Engl J Med 362 : 726 ~ 738 google schola Chng CL / 2012 / Ethnic di google schola Dragan LR / 2006 / Longitudinal correlation of thyroid-stimulating immunoglobulin with clinical activity of disease in thyroid-associated orbitopathy / Ophthal Plast Reconst google schola Eckstein AK / 2004 / Clinical results of anti-inflammatory therapy in Graves’ ophthalmopathy and association with thyroidal autoantibodies / Clin Endocrinol (Oxf ) 61 : 612 google schola Eckstein AK / 2006 / Thyrotropin receptor autoantibodies are independent risk factors for Graves’ophthalmopathy and help to predict severity and outcome of the disease / J google schola

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