Significance of determination of antibodies to thyroid-stimulating hormone after discontinuation of antithyroid therapy for Graves disease in children
Determination of thyroid-stimulating receptor antibodies (TSRA) a promising criterion for discontinuation of antithyroid drug therapy; however, such studies are extremely limited in childhood. The purpose of this investigation was to establish the prognostic value of TSRA on discontinuing antithyroid drug therapy in children with Craves' disease (CD). At the moment of therapy discontinuation, the level of TSRA was higher than the reference range in 15 of 31 children; there were very high values in 2 cases of hypothyroidism that preserved after discontinuation of antithyroid drug treatment. After omitting these cases while making an analysis, the authors ascertained that a relapse developed in 12 of the 13 children and following 3 months CD remission occurred in 1 case. Recurrent thyrothoxicosis occurred in 7 of the 16 patients with normal values of TSRA and 9 children were at remission. Analysis of a ROC-curve revealed that in children having a TSRA level of > 1.95 IU/l at the discontinuation of antithyroid drug therapy, the risk for recurrent thyrotoxicosis is 100% within the first year.