Anti-TSH receptor antibodies as predictors of the severity and outcome of endocrine ophthalmopathy in the patients presenting with Graves' disease

Abstract

A total of 139 patients (278 eyes) presenting with Graves' disease (GD) and endocrine ophthalmopathy (EOP) were examined. The age of 35 men and 104 women ranged from 17 to 71 years. All of them were tested for the functional activity of the thyroid gland and underwent standard ophthalmologic examination; anti-TSH receptor antibodies were measured. Both the activity and severity of EOP were verified as recommended by the European Group on Graves' Orbitopathy (EUGOGO) It was shown that the frequency of detection of anti-TSH receptor antibodies and their titers in patients with GD and EOP depended on the activity of the intraorbital process and the severity of EOP manifestations. The functional state of the thyroid gland also influenced the level of anti-TSH receptor antibodies level during the active phase unlike that in the inactive phase. The in-depth analysis of the relationship between the level of anti-TSH receptor antibodies and clinical characteristics of either EOP (activity, severity, manifestation of selected clinical symptoms) or GD (thyrotoxicosis, euthyroidism, hypothyroidism) demonstrated the possibility to use these characteristics as the factors predicting the severity and outcome of EOP. Also, they may be helpful for the choice of a therapeutic strategy for the treatment of such patients.