SIGNIFICANCE OF ANTITHYROGLOBULIN ANTIBODIES AND EXOPHTALMUS AS EARLY PREDICTORS OF THE EVOLUTION OF THE JUVENILE HYPERTHYROIDISM (JH)

Abstract

JH is a discouraging disease because of the need for long treatment which results in remissions in only 30% of patients. In a previous report we showed that thyroid function 2 years after treatment with antithyroid drugs (short-term) was a predictor of the long-term evolution (9.2 ± 3.3y.), since in 90% of patients no variation of thyroid status results. In this study our aim was to find “markers” at the begining of the disease which could predict its subsequent evolution. The presence (+) or absence (-) of Exophthalmus (E), antithyroid microsomal (Mi) and Anthithyroglobulin (Tg) antibodies at the beginning of the disease were evaluated retrospectively in 35 patients followed up for 4 to 17 years. Patients were divided according to whether in remission (R, n=13) or no remission (N.R. n=22). Patients in R had Tg⁺ in 82% (9/11); and Tg⁺ and E⁺ in 87,5% (7/8); NR with Tg⁻ in 83.3% (20/24) and Tg⁻ and E⁻: 91% (10/11); NR was associated with Mi in 4/4. Tg is a useful isolated early marker since it was frequently found in group R and absent in group NR. Mi⁺ is not reliable since is frequently present in both groups. On the contrary, Mi⁻ is a strong marker of no remission, although seldom found. When Tg and E are associated either both positive or negative, predictive value of there markers improves. These early markers are useful predictors of the evolution of JH. They can be used to avoid long medical treatments and to decide other therapeutic courses after 2 years of follow-up.

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