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KMID : 0356619950100030229
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Journal of Korean Society of Endocrinology
1995 Volume.10 No. 3 p.229 ~ p.241
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Changes in Thyrotropin Receptor Blocking Antibody after Antithyroid drug Administration to Patients with Atrophic Autoimmune Thyroiditis(Primary myxedema)
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김원배
조보연/신찬수/김성연/이홍규/고창순/정재훈
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Abstract
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It is well known that antithyroid drug treatment of Graves' disease suppresses excessive thyroid hormone synthesis and causes a parallel decrease in serum thyroid autoantibody levels including thyroid stimulating antibodies(TSAb) in most patients
suggesting the immunosuppressive or immunomodulating effects of antithyroid drugs. In the context of view that thyrotropin receptor blocking antibody may play an important pathogenetic role at least in some patients with primary myxedema(chronic
atrophic autoimmune thyroiditis), antithyroid drug treatment in these patients might be beneficial to disease course. To evaluate the effect of antithyroid drug on the thyrotropin receptor blocking antibody levels, we serially measured
thyrotropin-binding inhibitor immunoglobulins(TBII) and thyroid stimulation blocking antibodies(TSBAb) using FRTL-5 cells, antimicrosomal- and antithyroglobulin antibody activities in 7 patients with primary myedema who have blocking TSH receptor
antibodies during 6 months of methimazole(MMI, 40mg/day) administration.
TBII and TSBAb activities did not change after MMI, but one of them showed stepwise decrease and disappearance of TBII and TSBAb activities. Antimicrosomal- and antithyroglobulin antibody activities decreased significantly after 3 months of MMI
administration in those patients.
Thses results suggest a minimal effect of antithyroid drug treatment on the level of thyrotropin receptor bloking antibodies. Persistence ofthyrotropin receptor bloking antibodies despite of the decrease in antimicrosomal and antithyroglobulin
antibodies might suggest that blocking TSH receptor antibodies of primary myxedema is produced mainly in extrathyroidal tissue in contrast to the thyroid stimulating antibodies of Graves' disease. One patients, whose blocking antibody have
disappeared
after MMI treatment, is under observation to see if she will remain in remission of hypothyroidism(J Kor Soc Endocrinol 10:229~241, 1995).
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KEYWORD
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