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Euthyroid Graves' disease showing no thyroid abnormalities except positive thyroid-stimulating antibody (TSAb): two
M Watanabe1, Y Iwatani, T Kashiwai
1Department of Laboratory Medicine, Osaka University Medical School, Suita, Japan.
Journal of Internal Medicine
|October 1, 1995
Summary
Euthyroid Graves
Area of Science:
- Endocrinology
- Ophthalmology
- Immunology
Background:
- Graves' disease typically presents with hyperthyroidism.
- Euthyroid Graves' disease (EGD) involves ophthalmopathy without overt hyperthyroidism.
- Diagnosis of EGD can be challenging due to normal thyroid function tests.
Observation:
- Two women presented with Graves' ophthalmopathy but normal thyroid function.
- Magnetic resonance imaging (MRI) revealed extraocular muscle enlargement.
- Standard thyroid antibody tests (microsomal, thyroglobulin, anti-TSH receptor assay) were negative.
Findings:
- Thyroid-stimulating antibody (TSAb) measured by sensitive bioassay was the sole positive laboratory finding.
- Thyroid-stimulating antibody (TSAb) is crucial for diagnosing EGD.
- Sensitive TSAb assays are vital for identifying EGD.
Implications:
- Highlights the importance of TSAb testing in diagnosing EGD.
- Suggests TSAb is the most sensitive diagnostic marker for EGD.
- Improves understanding of EGD pathogenesis and diagnosis.