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KMID : 0616619980040020235
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Journal of Soonchunhyang Medical College
1998 Volume.4 No. 2 p.235 ~ p.245
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Study on the Factors influencing the Relapse of Graves´ Disease after Antithyroid Medication
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Abstract
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Background : Many studies were undertaken to find parameters that could predict the clinical course of patients with Graves´ disease after withdrawal of antithyroid drugs. In many parameters, TRH (thyrofiopin-releasing hormone) stirrarlation test and n suppression test were considered to be one of the most reliable for predicting remission. But recently, some studies showed that the measurement of free n and F´173 are to be a more accurate than other thyroid fi nction test In this study, we measured T3, T4, T3M TSH (thyroid stimulating hormone), TRAb (TSH receptor antibody), FM and other known useful parameters to compare the factors influencing the relapse of Graves disease after antithyroid medication.
Patients and methods : Among the 84 Graves´ disease patients who had done the TRH stimulation test after withdrawal of antithyroid medication, we examined 32 patients who showed normal TSH response and followed up more than one year. T3, T4, T3gT , TSH and TRAb levels were measured at the time of diagnosis and at the end of therapy. Serum TSH and FT3 levels were measured after TRH stimulation, after two months of withdrawal of medication.
Statistical evaluation was performed by SPSS software in combination with Student´ s paired Hest, chi-square test, Wlicoxon signed-ranks test. P-value less than 0.05 was considered to be significant
Results
1. In the 32 patients with Graves disease, 10 patients(310) relapsed(Group I) and 22 patients(69´9) remained in
rernission(Group 11).
2 Initial serum T3 level was significantly higher in group I than group 11(342.0 126.2 vs. 493.0142.2 ng/dl, p<0.05).
3 Anti-TPO Ab level was significantly higher in group I than group 11(22.322.3 vs 2.94.4 U/mL, p<0.05).
4 In group I and 11 most patients showed relapse within 1 year after antithyroid medication.
5 After TRH stimulation test, serum F4 and TSH level were not significantly different between group I and 14>0.05).
6 Serum T4, T3rT4, TSH, TRAb levels were not significantly different from group I and IL
Conclusion : In this study, we found increased relapse rate in the patients with Graves´ disease whose initial serum T3 and anti-1P0 Ab levels were high, so these parameters could be used to predict the relapse of Graves´ disease. In the case of more than 12 months remission period after withdrawal of antithyroid medication, no relapse wsa observed in this study, but study should be done in the large population of patients with Graves´ disease.
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