The Clinical Implications of Anti-thyroid Peroxidase Antibodies in Graves’ Disease in Basrah

Abstract

BackgroundGraves' disease (GD) is an autoimmune disease, with thyrotropin receptor antibodies (TRAbs) being the most important cause in the pathogenesis. The aim of this study is to assess the clinical significance of anti-TPO Abs in GD. MethodsA retrospective study was conducted at the Faiha specialized Diabetes, Endocrine, and Metabolism Center (FDEMC) in Basrah during the period between December 2021 and December 2022. A total of 141 patients with GD were involved in this study, and of them, 97 (68.8%) were women. They were divided into two groups: patients with positive and negative anti-TPO Abs groups. ResultsPositive anti-TPO Abs were seen in 83 patients (58.9%) with GD. Pretreatment-free thyroxine level (ng/dL) was higher in the anti-TPO Abs positive GD patients than in those with negative antibodies (3.7±0.2 versus 3.0±0.2 with a p=0.021). Similarly, higher TRAb titers (IU/ml) at baseline were also seen in patients with positive anti-TPO Abs (9.8±0.7 versus 6.8±0.8) with a p=0.008. Giraffe appearance on thyroid ultrasound was more common in the group with positive anti-TPO Abs as compared to patients with negative anti-TPO Abs: 20 (87.0%) versus 3 (13.0%) with a p=0.005. A higher anti-TPO Abs titer (IU/mL) was associated with a baseline TRAb level of more than 6.4 IU/mL, and giraffe appearance on thyroid ultrasound (206.5±20.0 p-value<0.0001 and 228.0±35.3 p value=0.007, respectively). ConclusionA positive anti-TPO Abs in GD is associated with a high TRAb titer and free T4 level at baseline, as well as a giraffe appearance on thyroid ultrasound.

Levels of Antithyroid Antiperoxidase and Antithyroglobulin Antibodies in Patients with Graves Hyperthyroidism – Predictors of Initial and Sustained Remission and Consecutive Hypothyroidism

“…Azizi et al found that patients with positive aTPO were associated with high baseline free T4, while not with thyroid eye disease [18]. Similar results were demonstrated by Alhubaish et al patients with aTPO antibodies versus those with negative antibodies showed higher pretreatment-FT4 level (3.7 ± 0.2 vs. 3.0 ± 0.2 with p = 0.021), baseline TRAb level of more than 6.4 IU/mL, and giraffe appearance on thyroid ultrasound [19].…”

Cytomorphological Profile of Graves' Disease and its Co-relation with anti-TPO Antibody

“…Carvalho et al, anti-TPO Abs were present in about 80% of patients, [23] Samsudin et al, anti-TPO Abs were present in about 62% of patients, [24] Almomin et al, 2019 anti-TPO Abs were present in about 60.4% of patients, [25] Siriwardhane et al, anti-TPO Abs were present in about 59.8%. of patients, [26] Sulejmanovic et al, anti-TPO Abs were present in about 71% of patients, [27] and Alhubaish et al, anti-TPO Abs were present in about 58.9% with GD [28] .…”