ARE SERUM NEOPTERIN CONCENTRATIONS SUPERIOR TO OTHER PARAMETERS IN THE DIFFERENTIAL-DIAGNOSIS AND PROGNOSTIC ASSESSMENT OF GRAVES-DISEASE

There is a lack (1.) of a single criterion for the definitve different iation between immunogenic (IH) and non-immunogenic hyperthyroidism (N IH), and (2.) also a lack of an unequivocal prognostic predictor for t he individual course of patients with immunogenic hyperthyroidism. In 152 patients scheduled for iodine-131 therapy, serum neopterin concent rations were measured using a commercially available RIA, and the neop terin concentrations of IH (n = 84) and NIH (n = 42) patients were com pared. Of these patients, 83 and 26 per cent respectively were treated with antithyroid drugs which did not have a significant impact on neo pterin levels. In patients with IH and NIH, the concentrations [mean /- SD] of neopterin were 1.89 +/- 0.79 mu g/l and 1.98 +/- 0.9 mu g/l, respectively (p = 0.4). After therapy with iodine-131, 28% of the IH- patients were euthyroid, 32% hyperthyroid, and 40% hypothyroid. In fin ally euthyroid patients, pretherapeutic neopterin concentrations were higher (3.1 +/- 2.8 mu g/l) than in finally hyperthyroid (1.8 +/- 0.7 mu g/l), or hypothyroid (1.6 +/- 0.7 mu g/l) patients. These results a rgue against a relevant clinical role of neopterin concentrations for the differential diagnosis of IH versus NIH in these patients. However , a prognostic significance of neopterin concentrations in patients wi th IH is suggested.