Thyroid-stimulating immunoglobulin levels during low-dose antithyroid therapy predict Graves' disease relapse

Area of Science:

• Endocrinology
• Immunology
• Autoimmune Diseases

Background:

• Graves' disease (GD) is a prevalent autoimmune disorder.
• Antithyroid drugs (ATD) are a common treatment, but relapse rates after discontinuation are high.

Purpose of the Study:

• To evaluate the predictive value of thyroid-stimulating immunoglobulin (TSI) levels for relapse in GD patients after ATD withdrawal.

Main Methods:

• Retrospective analysis of 349 GD patients.
• TSI levels measured via chemiluminescent immunoassay.
• 88 patients discontinued ATD and were monitored for relapse.

Main Results:

• Median TSI levels were significantly higher in relapsed patients (1.63 vs. 0.52 IU/L).
• A TSI cutoff of 1.31 IU/L showed 63.64% sensitivity and 78.79% specificity.
• Independent predictors of relapse included TSI ≥1.31 IU/L, treatment <18 months, and thyroid eye disease.

Conclusions:

• TSI measurement is a valuable tool for predicting GD relapse post-ATD.
• A TSI cutoff of 1.31 IU/L can assist clinical decisions.
• Prospective studies are needed to validate these findings.