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Thyroid.1997Jun7(3):36975.

ClinicalfeaturesofpatientswithGraves'diseaseundergoingremissionafterantithyroiddrugtreatment.
VittiP1,RagoT,ChiovatoL,PalliniS,SantiniF,FioreE,RocchiR,MartinoE,PincheraA.

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Abstract
Theclinicalcourseof306Graves'patientstreatedwithmethimazole(MMI)wasreviewedwiththeaimofestablishingcriteriaabletopredictremissionofhyperthyroidismaftermedicaltreatment.Onehundred
andninetyfour(149females,45males)of306(63.4%)patientshadrelapseofhyperthyroidismafterantithyroiddrug(ATD)withdrawal.Relapsewasmorefrequentduringthefirstmonthsofthefollowup,but
stillitwasobserved3yearsafterMMIwithdrawal.Therelapseratewasdependentontheageofthepatient,thesizeofgoiter,andthelevelofTSHreceptorantibody(TRAb)atdiagnosis,beingobservedin
40of47(85%)patientswithhigh(>30U/L)TRAblevelandin54of101(53%)patientswithlowTRAblevel(<or=30U/Lp<.0002).Remissionwasmorefrequent(43.3%)inpatientshavingthe
combinationgoitersize<or=40mL,TRAblevel<or=30U/L,thaninpatientswithgoitersize>40mLandhighTRAblevels(9%).Inthesubgroupofpatientswiththecombination:goiter<or=40mL
TRAb<or=30U/Lageatonset>40years,theremissionratewas80%,andallrelapsesoccurredwithinthefirst9monthsafterMMIwithdrawal.Inconclusion,ourstudyconfirmsthathyperthyroidism
relapsesinthemajorityofpatientswithGraves'diseasetreatedwithATD.Amongdifferentclinicalandlaboratoryfeatures,ageatonsetofhyperthyroidism,goitersizeandTRAblevelareparticularlyhelpfulin
identifyingthosepatientswhoaremorepronetoundergoaremissionofhyperthyroidismaftermedicaltreatmentandmaybeusefultoselecttheminorityofGraves'patientswhowillbenefitfromantithyroid
drugtreatmentasafirstchoice.
PMID:9226205[PubMedindexedforMEDLINE]

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