Prevalence of thyroid peroxidase, thyroglobulin and thyrotropin receptor antibodies in a long-term follow-up of juvenile Graves disease

Objective - To relate the presence of thyroid peroxidase antibodies (TPO ab ), thyroglobulin antibodies (Tg ab) and thyrotropin receptor antibodies (TS H-R ab) to the clinical course in a long-term follow-up of patients with ju venile Graves' disease (JGD). Design - Patients with JGD were drawn from a Danish retrospective study and reexamined. Results - A number of 105 patients were reexamined 4-21 years (median 10 ye ars) after diagnosis. Three groups were formed: Gr.1: euthyroid patients wi th anti-thyroid drug (ATD) cessation more than 12 months before reexaminati on (n=41). Gr.2: patients still on ATD (n=24). Gr.3: subtotally thyroidecto mized patients (n=40), Positive TPO ab titers were found in 75% of the pati ents. Tn 13% of the patients the titers were very high: >10,000 U/ml. Posit ive Tg ab were found in 51%. The prevalence of TPO ab and Tg ab was the low est in group 3. Stimulating TSH-R ab titers were found in 13%. No patients had blocking TSH-R ab. The prevalence of TSH-R ab was 3% in the euthyroid p atients, without surgery performed, 15% in the surgical patients, and 25% i n the patients still on ATD. Conclusions - Many JGD patients were euthyroid at the long-term follow-up i n spite of high TPO ab and Tg ab titers. Stimulating TSH-R ab were rare (13 %). According to this presence of TPO ab, Tg ab or TSH-R ab does not predic t the final outcome of JGD, Further studies are needed.