Effect of therapy duration and low and highly dosed thiamazole treatment in Basedow's-Graves' disease.
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Biomedical subjects
Publications and source records attributed to S Meng.
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The testing of a SCN- dose (32 mg NaSCN/kg oral 21 d long) which is about 100 fold above the alimentary SCN(-)-uptake on guinea pig has shown neither histologic/morphometrical nor clinical clue to thyrostatic effect. In 6 regions of the GDR (1,349 persons) has not been secured epidemiologically any relationship between SCN- serum level as well as SCN- urine level and goiter. The partly in the tendency low increase of SCN- level by patients with bland goiter was always under the levels of smokers without goiter, exceeded indeed the threshold of significance in the area of Werdau. In the industrial agglomeration areas the I(-)-SCN(-)-quotient at the most unfavourable cases ran to 3.5 (Halle, smoker, struma), was consequently close to the critical level of the goiter risk.
We tested the clinical valency of the TSH-receptor antibody (TBIAb) determination (TRAK assay, Fa. Henning) for the differential diagnostics of various diseases of the thyroid gland (n = 259), particularly of the hyperthyroidism. In 110 out of 114 basedowians TBAIAb could be proved (sensitivity 96%). The specifity to healthy persons (n = 20) was 100%, to the disseminated autonomy (n = 61) 92%. In 43 bland strumas and 22 cases of primary hypothyroidisms no circulating TBIAb were found. Of 40 cases of Basedow's hyperthyroidism the TBIAb titres were pursued during a 12-month methimazol therapy. In these cases was shown that negative antibody titres at the end of the treatment were connected with an essentially lower rate of early relapses than positive ones. Moreover, a highly dosed application of methimazol revealed a more favourable tendency than a low dosed one. From this we conclude that the TBIAb measurement with a commercial kit is a sensitive, sufficiently specific and practicable method for the differential diagnostics of hyperthyroidism and that to a certain degree it allows conclusions on the course of Basedow's disease after thyrostatic long-term therapy.
Acetylator phenotypes were determined with sulfamethazine in 114 healthy volunteers, 87 patients with immunogenic hyperthyroidism (Graves' disease) and 38 patients with disseminated thyroid autonomies. About 90% of the patients were females. No significant differences of acetylator phenotypes were observed between female volunteers and hyperthyreotic patients younger than 50 years. The proportion of slow acetylators was higher in older patients. Early and late relapses did not depend on acetylator status.
Up to now the results of drug treatment are unsatisfying. Treatment of more than 1-2 years did not decrease the occurrence of relapses. Thyroid suppression test and TRH test give the same indications concerning the outcome in cases with Graves' disease and disseminated autonomy (short-time prognosis). The relapse rate is distinctly higher in Graves' disease than in cases with disseminated autonomy (goitre class 3 excluded).
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