Prognostic value of thyroid stimulating antibodies and TSH-binding inhibiting immunoglobulins in the follow-up of Graves' disease

1985 ◽  
Vol 63 (24) ◽  
pp. 1247-1252 ◽  
Author(s):  
R. Hörmann ◽  
B. Saller ◽  
R. Müller ◽  
K. Mann
Keyword(s):  
Prognostic Value ◽  
Graves Disease ◽  
Thyroid Stimulating Antibodies

scholarly journals The Prognostic Value of Thyroid Stimulating Immunoglobulin in the Management of Graves’ Disease

2020 ◽  
Author(s):  
Xinxin Chen ◽  
Yulin Zhou ◽  
Mengxi Zhou ◽  
Yicheng Qi ◽  
Weiqing Wang ◽  
...  
Keyword(s):  
Prognostic Value ◽  
Hashimoto Thyroiditis ◽  
Diagnostic Value ◽  
Graves Disease ◽  
Antibody Assay ◽  
End Of Treatment ◽  
Binding Inhibition ◽  
Thyroid Receptor ◽  
Commercial Kits

Abstract Background: The bioassay of thyroid-stimulating immunoglobulin (TSI) appears to be more sensitive than the commonly used TSH binding inhibition assay (TBII), also known as thyroid receptor antibody assay or TRAb.Methods: An observational study was conducted to evaluate the prognostic value of TSI in clinic. Patients with different etiologies of thyrotoxicosis were enrolled to verified the diagnostic value of TSI.Results: 77 Graves’ disease (GD) patients who were treated with anti-thyroid drug (ATD) were in a continuous follow-up until 1 year after ATD discontinuation. Commercial kits of TSI (Thyretain™) and M22-TBII were used and compared. TSI was all negative in healthy controls, Hashimoto thyroiditis, subacute thyroiditis. TSI value was highest in untreated GD patients (P < 0.001). Under ATD treatment, TSI value decreased gradually. 21 patients had positive TSI at the end of treatment. According to clinical fate of patients with GD after withdrawal ATD, TSI value and positivity in patients with relapse were significantly higher than that reported in patients with remission (P = 0.001, P < 0.001). After adjustment for age, gender, initial TRAb, initial TSI, and TRAb at the end of treatment, the odds ratio (OR) of positive TSI for the risk of relapse was 33.271 (95% confidence interval [CI]: 4.741-233.458, P < 0.001) and OR of quantitative TSI was 1.009 (95% CI: 1.002–1.015, P < 0.001).Conclusions: TSI is a good predictor of relapse in patients with GD subjected to ATD treatment. It might be safer to discontinue ATD when TSI and TRAb were both negative.

Prognostic value of TSAb- and TBII-activity in the follow-up of patients with Graves' disease on methimazole treatment

1985 ◽  
Vol 110 (1_Suppla) ◽  
pp. S68-S69
Author(s):  
R. HÖRMANN ◽  
B. SALLER ◽  
R. MÜLLER ◽  
K. MANN
Keyword(s):  
Prognostic Value ◽  
Graves Disease

1089: Prognostic Value of Molecular Staging of Bladder Cancer with RT -PCR Assay for KRT20: Results at 5 Year-Follow-up

2007 ◽  
Vol 177 (4S) ◽  
pp. 360-360
Author(s):  
Ana Agud ◽  
Maria J. Ribal ◽  
Lourdes Mengual ◽  
Mercedes Marin-Aguilera ◽  
Laura Izquierdo ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Prognostic Value ◽  
Rt Pcr ◽  
Pcr Assay ◽  
Molecular Staging

733: The Prognostic Value of E-Cadherin, Alpha-, and Beta-Catenin in Invasive Bladder Cancer Patients: Long Term Follow-Up Study

2004 ◽  
Vol 171 (4S) ◽  
pp. 194-195
Author(s):  
Kyoichi Tomita ◽  
Haruki Kume ◽  
Keishi Kashibuchi ◽  
Satoru Muto ◽  
Shigeo Horie ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Cancer Patients ◽  
Prognostic Value ◽  
Invasive Bladder Cancer ◽  
Beta Catenin ◽  
Follow Up Study ◽  
Long Term Follow Up ◽  
E Cadherin

Short- and Long-Term Results of Total vs Subtotal Thyroid- ectomies in the Surgical Treatment of Graves' Disease

Swiss Surgery ◽  
2001 ◽  
Vol 7 (1) ◽  
pp. 20-24 ◽  
Author(s):  
Robert ◽  
Mariéthoz ◽  
Pache ◽  
Bertin ◽  
Caulfield ◽  
...  
Keyword(s):  
Recurrent Laryngeal Nerve ◽  
Nerve Palsy ◽  
Recurrent Laryngeal Nerve Palsy ◽  
Laryngeal Nerve ◽  
Long Term Results ◽  
Graves Disease ◽  
Laryngeal Nerve Palsy ◽  
Short And Long Term

Objective: Approximately one out of five patients with Graves' disease (GD) undergoes a thyroidectomy after a mean period of 18 months of medical treatment. This retrospective and non-randomized study from a teaching hospital compares short- and long-term results of total (TT) and subtotal thyroidectomies (ST) for this disease. Methods: From 1987 to 1997, 94 patients were operated for GD. Thirty-three patients underwent a TT (mostly since 1993) and 61 a ST (keeping 4 to 8 grams of thyroid tissue - mean 6 g). All patients had received propylthiouracil and/or neo-mercazole and were in a euthyroid state at the time of surgery; they also took potassium iodide (lugol) for ten days before surgery. Results: There were no deaths. Transient hypocalcemia (< 3 months) occurred in 32 patients (15 TT and 17 ST) and persistent hypocalcemia in 8 having had TT. Two patients developed transient recurrent laryngeal nerve palsy after ST (< 3 months). After a median follow-up period of seven years (1-15) with five patients lost to follow-up, 41 patients having had a ST are in a hypothyroid state (73%), thirteen are euthyroid (23%), and two suffered recurrent hyperthyroidism, requiring completion of thyroidectomy. All 33 patients having had TT - with follow-ups averaging two years (0.5-8) - are receiving thyroxin substitution. Conclusions: There were no instances of persistent recurrent laryngeal nerve palsy in either group, but persistent hypoparathyroidism occurred more frequently after TT. Long after ST, hypothyroidism developed in nearly three of four cases, whereas euthyroidy was maintained in only one-fourth; recurrent hyperthyroidy was rare.

scholarly journals Prognostic value of NT-proBNP for myocardial recovery in peripartum cardiomyopathy (PPCM)

2021 ◽  
Author(s):  
J. Hoevelmann ◽  
E. Muller ◽  
F. Azibani ◽  
S. Kraus ◽  
J. Cirota ◽  
...  
Keyword(s):  
Prognostic Value ◽  
Systolic Function ◽  
Point Of Care ◽  
Diagnostic Value ◽  
Left Ventricular ◽  
Peripartum Cardiomyopathy ◽  
Lv Function ◽  
Myocardial Recovery ◽  
End Diastolic Volume

Abstract Introduction Peripartum cardiomyopathy (PPCM) is an important cause of pregnancy-associated heart failure worldwide. Although a significant number of women recover their left ventricular (LV) function within 12 months, some remain with persistently reduced systolic function. Methods Knowledge gaps exist on predictors of myocardial recovery in PPCM. N-terminal pro-brain natriuretic peptide (NT-proBNP) is the only clinically established biomarker with diagnostic value in PPCM. We aimed to establish whether NT-proBNP could serve as a predictor of LV recovery in PPCM, as measured by LV end-diastolic volume (LVEDD) and LV ejection fraction (LVEF). Results This study of 35 women with PPCM (mean age 30.0 ± 5.9 years) had a median NT-proBNP of 834.7 pg/ml (IQR 571.2–1840.5) at baseline. Within the first year of follow-up, 51.4% of the cohort recovered their LV dimensions (LVEDD < 55 mm) and systolic function (LVEF > 50%). Women without LV recovery presented with higher NT-proBNP at baseline. Multivariable regression analyses demonstrated that NT-proBNP of ≥ 900 pg/ml at the time of diagnosis was predictive of failure to recover LVEDD (OR 0.22, 95% CI 0.05–0.95, P = 0.043) or LVEF (OR 0.20 [95% CI 0.04–0.89], p = 0.035) at follow-up. Conclusions We have demonstrated that NT-proBNP has a prognostic value in predicting LV recovery of patients with PPCM. Patients with NT-proBNP of ≥ 900 pg/ml were less likely to show any improvement in LVEF or LVEDD. Our findings have implications for clinical practice as patients with higher NT-proBNP might require more aggressive therapy and more intensive follow-up. Point-of-care NT-proBNP for diagnosis and risk stratification warrants further investigation.

Regional cardiac uptake of 99-Tc-DPD is a novel powerful and independent prognostic marker in cardiac ATTR wild type amyloidosis

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
P Milani ◽  
G Cavenaghi ◽  
L Obici ◽  
R Mussinelli ◽  
C Klersy ◽  
...  
Keyword(s):  
Prognostic Value ◽  
Cox Regression ◽  
Expectation Maximization Algorithm ◽  
Linear Increase ◽  
Whole Body ◽  
Wall Region ◽  
Cardiac Spect ◽  
Risk Of Death ◽  
Cardiac Wall

Abstract Background Skeletal scintigraphy with bone tracers is a key tool for cardiac ATTR diagnosis. However its prognostic value has not been systematically assessed. Purpose We evaluated the prognostic relevance of a quantitative method to assess regional 99mTc-DPD uptake by SPECT in the heart of ATTRwt patients. Methods All ATTRwt patients (n=229) undergoing clinical assessment and bone scintigraphy at our center (from 2012 to 2019) were enrolled. Theyreceived approximately 700 MBq of 99mTc-DPD. Planar whole body acquisition 10' after the injection followed by cardiac SPECT after 3 hours were performed. SPECT data were reconstructed into 64x64 matrices with an ordered-subset expectation maximization algorithm. For each wall region and for the apex, a circular region of interest (ROI, 20 pixels) was manually drawn and a value equating to the number of counts contained in the ROI was obtained. Partial correlation of ln-transformed ROI and biomarkers was retrieved from a multivariable regression model, while controlling for each cardiac wall region. Multivariable Cox regression was used to assess the prognostic role of lnROI while adjusting for wall region, NT-proBNP, cTnI and eGFR. Hazard ratios and 95% confidence intervals (HR, 95% CI) were computed. The Harrell's c statistic was reported for model discrimination. The interaction of biomarker and regional wall on survival was assessed; also, to account for intra-subject correlation of measures, within subject robust standard errors were computed. Results Median follow-up was 21 months (IQR 11, 40) and 39 (17%) patients died. Median age was 76 years (IQR, 72–80), NT-proBNP 2944 ng/L (IQR, 1815–5319), cTnI 0.095 ng/L (IQR, 0.062–0.144) and eGFR 62 mL/min (IQR, 51–77). ROI did not correlate with any of NT-proBNP, eGFR, age, cTnI or mLVWT (R&lt;1% in all cases). All analyses were adjusted for cardiac wall. At the multivariable Cox regression (Harrell's c=0.75), there was a linear increase in the risk of death associated with lnROI (HR 2.14, P=0.014), which was independent of cardiac wall region, NTproBNP, cTnI and eGFR. Only cTnI maintained a significant prognostic value. The association of lnROI and mortality was not modified by the site of measurement test for interaction with cardiac wall p=0.818). At the predefined subgroup analysis, the risk of death was similar for all walls; we computed the optimal cut-off for 12 months survival at the apex (a region usually lately involved) to 4193 (AUC: 0.68, sensitivity 80%, specificity 68%). At the multivariable Cox regression (Harrell's c 0.76), apex ROI&gt;4193 was an independent predictor of death (HR 3.60, 95% CI 1.45–8.93, p=0.006) and outperformed all the biomarkers tested. Conclusions Quantitative assessment of ROI uptake at cardiac SPECT is a powerful predictor of survival in ATTRwt patients, independent of and outperforming the other known prognostic factors. This observation warrants validation with prolonged follow-up and in independent patient series. Funding Acknowledgement Type of funding source: None

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