Serum thyroglobulin and its autoantibody following subtotal thyroid resection of Graves' disease

1982 ◽  
Vol 12 (3) ◽  
pp. 203-208 ◽  
Author(s):  
ULLA FELDT-RASMUSSEN ◽  
M. BLICHERT-TOFT ◽  
C. CHRISTIANSEN ◽  
J. DATE
Keyword(s):  
Graves Disease ◽  
Serum Thyroglobulin ◽  
Thyroid Resection

Impact of the serum thyroglobulin concentration on the diagnostics of benign and malignant thyroid diseases

2000 ◽  
Vol 39 (05) ◽  
pp. 133-138 ◽  
Author(s):  
W. Dembowski ◽  
H.-J. Schroth ◽  
K. Klinger ◽  
Th. Rink
Keyword(s):  
Hashimoto’S Thyroiditis ◽  
Thyroid Volume ◽  
Nodular Goiter ◽  
Thyroid Diseases ◽  
Hashimoto's Thyroiditis ◽  
Graves Disease ◽  
Normal Range ◽  
Serum Thyroglobulin ◽  
Diffuse Goiter ◽  
Hyperthyroid Patients

Summary Aim of this study is to evaluate new and controversially discussed indications for determining the thyroglobulin (Tg) level in different thyroid diseases to support routine diagnostics. Methods: The following groups were included: 250 healthy subjects without goiter, 50 persons with diffuse goiter, 161 patients with multinodular goiter devoid of functional disorder (108 of them underwent surgery, in 17 cases carcinomas were detected), 60 hyperthyroid patients with autonomously functioning nodular goiter, 150 patients with Hashimoto’s thyroiditis and 30 hyperthyroid patients with Graves’ disease. Results: The upper limit of the normal range of the Tg level was calculated as 30 ng Tg/ml. The evaluation of the collective with diffuse goiter showed that the figure of the Tg level can be expected in a similar magnitude as the thyroid volume in milliliters. Nodular tissue led to far higher Tg values then presumed when considering the respective thyroid volume, with a rather high variance. A formula for a rough prediction of the Tg levels in nodular goiters is described. In ten out of 17 cases with thyroid carcinoma, the Tg was lower than estimated with thyroid and nodular volumes, but two patients showed a Tg exceeding 1000 ng/ml. The collective with functional autonomy had a significantly higher average Tg level than a matched euthyroid group being under suppressive levothyroxine substitution. However, due to the high variance of the Tg values, the autonomy could not consistently be predicted with the Tg level in individual cases. The patients with Hashimoto’s thyroiditis showed slightly decreased Tg levels. In Graves’ disease, a significantly higher average Tg level was observed compared with a matched group with diffuse goiter, but 47% of all Tg values were still in the normal range (< 30 ng/ml). Conclusion: Elevated Tg levels indicate a high probability of thyroid diseases, such as malignancy, autonomy or Graves’ disease. However, as low Tg concentrations cannot exclude the respective disorder, a routine Tg determination seems not to be justified in benign thyroid diseases.

scholarly journals Identification of thyroid hormone residues on serum thyroglobulin: a clue to the source of circulating thyroglobulin in thyroid diseases

1999 ◽  
Vol 140 (5) ◽  
pp. 457-467 ◽  
Author(s):  
L Druetta ◽  
H Bornet ◽  
G Sassolas ◽  
B Rousset
Keyword(s):  
Monoclonal Antibody ◽  
Differentiated Thyroid Cancer ◽  
Follicular Carcinoma ◽  
Iodine Content ◽  
Graves Disease ◽  
Thyroid Disorders ◽  
Step Method ◽  
Serum Thyroglobulin ◽  
Normal Individuals ◽  
First Time

Thyroglobulin (Tg) present in the serum of normal individuals and patients with thyroid disorders could be partly newly synthesized non-iodinated Tg and partly Tg containing iodine and hormone residues originating from the lumen of thyroid follicles. With the aim of examining the contribution of the latter source of Tg to the elevation of serum Tg concentration in thyroid pathophysiological situations, we devised a procedure to identify thyroxine (T4) and tri-iodothyronine (T3) residues on Tg from unfractionated serum. A two-step method, basedon (i)adsorption of Tg on an immobilized anti-human Tg (hTg) monoclonal antibody (mAb) and (ii)recognition of hormone residues on adsorbed Tg by binding of radioiodinated anti-T4 mAb and anti-T3 mAb, was used to analyze serum Tg from patients with either Graves' disease (GD), subacute thyroiditis (ST) or metastatic differentiated thyroid cancer (DTC). Purified hTg preparations with different iodine and hormone contents were used as reference. Adsorption of purified Tg and serum Tg on immobilized anti-hTg mAb ranged between 85 and 90% over a wide concentration range. Labeled anti-T4 and anti-T3 mAbs bound to adsorbed purified Tg in amounts related to its iodine content. Tg adsorbed from six out of six sera from ST exhibited anti-T4 and anti-T3 mAb binding activities. In contrast, significant mAb binding was only observed in one out of eight sera from untreated GD patients and in 1 out of 13 sera from patients with DTC. The patient with DTC, whose serum Tg contained T4 and T3, represented a case of hyperthyroidism caused by a metastatic follicular carcinoma. In conclusion, we have identified, for the first time, T4 and T3 residues on circulating Tg. The presence of Tg with hormone residues in serum is occasional in GD and DTC but is a common and probably distinctive feature of ST.

Treatment of Graves' disease by carbimazole: high dose with thyroxine compared to titration dose

1994 ◽  
Vol 131 (2) ◽  
pp. 120-124 ◽  
Author(s):  
CJ Edmonds ◽  
M Tellez
Keyword(s):  
Cigarette Smoking ◽  
Comparative Study ◽  
Graves Disease ◽  
High Dose ◽  
Thyroid Antibodies ◽  
Serum Thyroglobulin ◽  
Northwick Park Hospital ◽  
Stopping Treatment ◽  
Park Hospital

Edmonds CJ, Tellez M. Treatment of Graves' disease by carbimazole: high dose with thyroxine compared to titration dose. Eur J Endocrinol 1994;131:120–4. ISSN 0804–4643 A comparative study of high-dose (HD, carbimazole 60 mg plus thyroxine 100–150 μg daily) and titration-dose (TD) regimens of carbimazole was carried out in 70 patients with Graves' disease, the patients being assigned randomly to one or other regimen. The treatment was given for 1 year and follow-up was for 2 years after stopping treatment. In both groups, recurrence of hyperthyroidism occurred, most commonly during the first 6 months (35% of HD and 44% of TD). By 2 years after stopping treatment, recurrence had occurred in 50% of the HD and 66% of the TD group. The differences were not significant. Thyroid antibodies, serum thyroglobulin and pertechnetate uptake fell similarly in both groups during treatment. Cigarette smoking was similar in both the groups and did not influence the frequency of relapse. In both HD and TD groups, when relapsing patients were examined according to whether they relapsed early (within 6 months or less) or late it was found that those who relapsed late were, in respect of goitre size, pertechnetate uptake and presence of detectable plasma TSH, similar to the patients who did not relapse at all. In conclusion, the changes in the measured variables and the progress of the patients was similar whether treated by the HD or TD regimen. CJ Edmonds, Northwick Park Hospital, Watford Road, Harrow, Middlesex HA1 3UJ, UK

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