Changes in TSH receptor antibody levels (TRAb) as markers of effectiveness of various therapies in Graves-Basedow's disease.

The aim of the study was to evaluate the usefulness of TRAb determinations in predicting and monitoring the effectiveness of various forms of treatment in Graves-Basedow's disease. 144 patients with Graves-Basedow's disease aged 18-76 years, x-44 were studied. Group I--54 patients treated with methizole, group II--45 patients treated with 131 I, group III--45 patients subjected to operative procedures. The TSH receptor antibodies were determined using the radioimmunoassay (TRAK-assay, Henning). The examinations were performed before, 12 and 18 months after treatment. Irrespective of the treatment type, the highest initial TRAb values were observed in the groups of patients with ineffective treatment (thiamazole x- 54.39+/-31.23 U/l, radioiodine x- 103.61+/-43.90 U/l, operative procedures x- 104.00+/- 52.34 U/l). During the 12-month follow-up of the patients subjected to surgery and 18-month follow-up of those undergoing conservative treatment, the level of antibodies did not normalize (x- 40.17+/-33.06, x- 77.18+/-44.92, x- 58.77+/-54.67, respectively). In the groups with effective treatment, the TRAb levels normalized. 1. The level of TSH receptor antibodies is a good marker for monitoring the effectiveness of treatment in Graves-Basedow's disease. 2. The high initial antibody level, irrespective of the kind of treatment instituted, is a bad prognostic feature. 3. The TRAb determinations performed 12 months after the institution of treatment also show some prognostic value. 4. The lack of normalization of antibody levels during treatment is associated with persistent hyperthyroidism, irrespective of the form of therapy.