| ORIGINAL ARTICLE |
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| Year : 2023 | Volume
: 8
| Issue : 1 | Page : 7-12 |
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Prediction of the recurrence risk of Graves' disease after antithyroid drug therapy
Qiang Zhang, Ying Fu
Center for Endocrine Metabolism and Immune Diseases, Beijing Luhe Hospital, Capital Medical University; Center for Endocrine Metabolism and Immune Diseases, Beijing Key Laboratory of Diabetes Research and Care, Beijing, China
Correspondence Address:
Ying Fu
M.D, Center for Endocrine Metabolism and Immune Diseases, Beijing Luhe Hospital, Capital Medical University, Beijing 101149; Beijing Key Laboratory of Diabetes Research and Care, Beijing 101149
China
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/ed.ed_23_22
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Objective: This study aimed at observing the prognostic factors for Graves' disease (GD) recurrence after treatment with antithyroid drugs.
Patients and Methods: Clinical data for 247 patients with primary GD hyperthyroidism diagnosed in the endocrinology department of our hospital between March 2014 and February 2017 were collected. Age, sex, thyroid size, thyroid hormone levels, thyrotropin receptor antibody (TRAb), thyroglobulin antibody, thyroid peroxidase antibody, urinary iodine, and other prognostic factors before and after treatment were analyzed and compared.
Results: After ATD treatment, 151 cases were in remission and 96 cases were not. The mean age at diagnosis was 37.3 ± 14.0 years in the remission group and 31.2 ± 12.2 years in the nonremission group (P = 0.032). The levels of free triiodothyronine (FT3) in the nonremission group and remission group were 25.7 ± 8.4 and 18.3 ± 9.1 pmol/L, respectively. The proportion of patients with goiter and thyroid-associated orbitopathy was higher in the nonremission group than the remission group. Similarly, both the FT3/FT4 ratio (4.63 ± 1.08 and 3.72 ± 0.69, P = 0.020) and TRAb level (27.4 ± 10.7% and 18.1 ± 9.8%, P = 0.001) significantly increased. Logistic regression analysis indicated that high thyroid volume (odds ratio [OR] =9.647, P = 0.003), high free T3/free T4 ratio (OR = 1.541, P = 0.019), and TRAb level (OR = 1.317, P = 0.002) were independent factors influencing drug treatment failure and were associated with poor prognosis. After drug withdrawal, patients with distinctly enlarged thyroid glands, thyroid-associated eye disease, and low serum thyroid-stimulating hormone (sTSH) levels were higher in the nonremission group than in the remission group.
Conclusion: GD patients with goiter, high TRAb level and high FT3/FT4 ratio had poor poor response to drugs. The recurrence rate was high in patients with thyroid-related eye disease, and sTSH delayed recovery.
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