Changes in Thyroid-Stimulating Antibody Activity in Graves' Disease Treated with Antithyroid Drug and Its Relationship to Relapse: A Prospective Study*

Abstract

Thyroid-stimulating antibodies (TSAb) were found in 51 patients (83.6%) with untreated Graves'' disease. The mean TSAb index reached the normal level after 6 mo. of antithyroid drug therapy [propylthiouracil or carbimazole]. In 9 patients (14.8%), TSAb remained persistently positive during and after antithyroid drug therapy, and relapse occurred in all. In 42 patients (68.8%), TSAb indices gradually returned to the normal range after drug treatment was started; in 38% of these, remission was maintained after treatment was stopped; in another 40.5%, relapse occurred when they were TSAb-positive and the remaining 21.5% relapsed despite return of TSAb indices to the normal range. A positive TSAb index at the end of drug treatment was a useful indicator in predicting subsequent relapse because, with 1 exception, all patients who were still TSAb positive at drug withdrawal relapsed subsequently.