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Thyroid-stimulating autoantibodies may yield relevant biomarkers for pediatric Graves’ disease
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Recent data suggest that thyroid-stimulating autoantibodies are sensitive and specific biomarkers for the diagnosis of pediatric Graves’ disease.
The international cross-sectional retrospective study carried out by Tanja Diana, MS, of the Gutenberg University Medical Center in Mainz, Germany, and colleagues included 422 serum samples from 157 children with Graves’ disease, 101 controls with other thyroid and non-thyroid autoimmune diseases, and 50 healthy children. Thyroid-stimulating autoantibodies (TSAb) and TSH-binding inhibitory immunoglobulins (TBII) were measured along with parameters of thyroid function.
“In the 82 untreated children with [Graves’ disease] and [Graves’ orbitopathy], sensitivity, specificity, positive and negative predictive values for TSAb and TBII were 100% and 92.68% (P=.031), 100% and 100%, 100% and 100%, 100% and 96.15%, respectively,” researchers wrote.
Children with Graves’ disease demonstrated the presence of TSAb (n=147; 94%) and TBII (n=138; 87.9%, P<.039), according to data. Moreover, TSAb and TBII serum levels were positively correlated (P<.001) in all children with just Graves’ disease, whereas a correlation was observed in children (n=75) with Graves’ orbitopathy (P<.001).
Children with hyperthyroidism and Graves’ orbitopathy displayed greater TSAb levels compared with those with thyroidal Graves’ disease only (P<.0001), researchers wrote.
After a median duration of 3 years of antithyroid drug treatment, there was a 69% decrease in TSAb levels in those with Graves’ disease vs. 20% in those with Graves’ orbitopathy (P<.001), according to data.
“In addition to being a useful biomarker for disease activity, TSAb also correlated with the presence of [Graves’ orbitopathy] independent of thyroid function, suggesting a possible causal role of TSAb in the immunopathogenesis of [Graves’ orbitopathy] and in the development of the clinical phenotype of thyroid eye disease with proptosis,” researchers wrote.
Disclosure: One researcher reports consultancy and funding from Quidel Corp. All other researchers report no relevant financial disclosures.
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