REMISSION WITH CARBIMAZOLE THERAPY AND ASSESSMENT OF T4 SUPPRESSION TEST AS AN INDEX OF RELAPSE IN PATIENTS WITH GRAVES-DISEASE IN INDIA

This study determined the relapse rate following the use of antithyroi d drugs (ATD) in patients with Graves' disease and assessed T4 suppres sion test as a follow up index for predicting relapse after carbimazol e treatment in 21 patients who had taken 9-12 months of ATD treatment continuously with good compliance. T4 suppression test was done before stopping ATD treatment. During one year of follow up after stopping A TD therapy, 12 (57%) patients relapsed and 9 (43%) remained in remissi on. Six of the 12 relapses occurred in the first 3 months of stopping ATD therapy. The response following the use of carbimazole therapy was comparable to that reported from iodine sufficient western countries and may be because of the salt iodination programme in our country. T4 suppression test was normal in 14 (66%) and abnormal in 7 (34%) patie nts. All the patients with abnormal T4 suppression test relapsed after stopping ATD. The overall accuracy of the T4 suppression test (76%) a lso favourably compared with reported values of other useful but less readily available markers such as thyrotropin releasing hormone (TRH) stimulation test and thyroid receptor antibodies. Thus, in our experie nce antithyroid drugs were able to induce long term remission in 43 pe r cent patients with Graves' disease and abnormal T4 suppression test call he used as a reliable parameter for predicting relapse.