10 years experience with consecutive measurement of thyrotropin binding inhibiting antibodies (TBIAb)

In the present study we reviewed 230 patients in whom thyrotropin-binding inhibiting antibodies (TBIAb) follow-up determinations had been performed up to 10 yr after hyperthyroidism had first developed. In 104 patients, Graves' ophthalmopathy occurred at some time in the course of the observation period. Fourty-four of these patients with Graves' ophthalmopathy had at least one, and up to four relapses after each one-year course of antithyroid drug therapy with methimazole. The addition of TBIAb-positive results over an observation period of 1-10 yr showed positive cumulative findings in 95% of the 44 patients with recurrences of Graves' disease. A single TBIAb determination during hyperthyroidism showed positive results in 70%. A detailed breakdown showed that TBIAb was detectable during all hyperthyroid phases in 48% of the patients with ophthalmopathy. Thirty-four per cent of the patients had sometimes positive, sometimes negative TBIAb findings in the various hyperthyroid states. In 18% of the patients, TBIAb was not detected in any of the hyperthyroid phases. However, some of these patients became TBIAb-positive for the first time during antithyroid drug therapy or during a remission confirmed by a suppression test. Only 2 of the 44 patients never had TBIAb positive results at any time during the observation period. In those patients without ophthalmopathy during the observation period, the "cumulative" frequency of TBIAb was 74% for patients with diffuse goiter and 52% for patients with diffuse-nodular goiter. However, in patients with ophthalmopathy, there was no difference in TBIAb detectability between those patients with a diffuse and those with a diffuse-nodular thyroid.