J Korean Ophthalmol Soc.  2010 Sep;51(9):1167-1173. 10.3341/jkos.2010.51.9.1167.

Association Between Thyroid Associated Ophthalmopath and Thyroid Autoantibody

• Hwang DJ
• Kim YJ

• KMID: 2122281
• DOI: http://doi.org/10.3341/jkos.2010.51.9.1167

Abstract

PURPOSE
The same autoimmune process is thought to cause thyroid associated ophthalmopathy (TAO) and Graves' disease. The aim of this study is to determine hether thyroid autoantibody is related to the development of thyroid associated ophthalmopathy.
METHODS
A retrospective chart analysis was performed on patients with a newly diagnosed Graves' disease, who presented to our ophthalmology clinic between January 2006 and December 2009. Thyroid autoantibody titers were obtained at the time of diagnosis and were used to determine the presence or absence of TAO. In addition, any correlations between thyroid autoantibodies were analyzed in patients with TAO.
RESULTS
Thyroid autoantibody levels correlated with the development of TAO. Fifty-eight (69%) out of 84 patients with positive thyroid-stimulating hormone receptor antibody (TRAB) levels at the time of diagnosis had TAO. Only 50 (51%) of the 99 patients with negative TRAB levels had TAO. This difference between the two groups was statistically significant (odds ratio, OR=2.2, p=0.013). A statistically significant correlation with the development of TAO was also found in thyroid peroxidase antibody (TPOAb) and anti-thyroglobulin antibody (TgAb), respectively (OR=0.5, p=0.317; OR=0.3, p=<0.001). In patients with TAO, the correlation between TPOAb and TgAb levels was very high (r=0.64, p=<0.001).
CONCLUSIONS
A significant association was determined to exist between the development of TAO and thyroid autoantibody level. This result demonstrates the clinical utility of thyroid autoantibody for the diagnosis of TAO in patients with newly diagnosed Graves' disease.

Keyword

Anti-thyroglobulin antibody; Thyroid associated ophthalmopathy; Thyroid peroxidase antibody; Thyroid stimulating hormone receptor antibody

MeSH Terms

Autoantibodies
Graves Disease
Graves Ophthalmopathy
Humans
Iodide Peroxidase
Ophthalmology
Retrospective Studies
Thyroid Gland
Thyrotropin
Troleandomycin
Autoantibodies
Iodide Peroxidase
Thyrotropin
Troleandomycin

Figure

• 

  Figure 1 Number of patients with positive TRAB, TPOAb, and TgAb levels according to increasing CAS. TRAB= thyroid stimulating hormone receptor antibody; TPOAb= thyroid peroxidase antibody; TgAb=anti-thyroglobulin antibody.

• 

  Figure 2 Association between the CAS and the prevalence of TRAB, TPOAb and TgAb. The prevalence of TRAB increased with increasing CAS. However, the difference of the prevalence of TRAB was statistically insignificant. The prevalence of TPOAb and TgAb were not different among two groups. TRAB=thyroid stimulating hormone receptor antibody; TPOAb=thyroid peroxidase antibody; TgAb=anti-thyroglobulin antibody.

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  Figure 3 The prevalnce of immunological parameters in 184 patients with newly diagnosed, untreated thyroid disease. Fifty-eight (53%) of 108 patients with TAO had positive TRAB levels. Only 26 (35%) of the 75 non-TAO patients had positive TRAB levels. The chi-square tests for trend were statistically significant for all antibodies, respectively (P=0.013, 0.032 and <0.001). TAO=thyroid associated ophthalmopathy; TRAB=thyroid stimulating hormone receptor antibody; TPOAb=thyroid peroxidase antibody; TgAb=anti-thyroglobulin antibody.

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