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Biomedical subjects

W J Irvine

Publications and source records attributed to W J Irvine.

At least 19 recordsLinked to original sources
PubMed1979

Failure of the TRH test to predict the clinical course of patients in remission after antithyroid drug therapy for Graves' disease.

In an attempt to assess the predictive value of the TRH test in patients in remission after stopping antithyroid drugs for thyrotoxicosis, 11 euthyroid patients with a subnormal (group I) and 23 euthyroid patients with a normal serum TSH response to TRH (group II) were followed-up for one year. The mean +/- SE intervals since the withdrawal of drug therapy were 23.2 +/- 1.6 and 20.4 +/- 0.7 months, respectively, at the outset of the study. Five patients (45%) from group I and 7 patients (30%) from group II relapsed during the period of observation. In addition, a change from a subnormal TSH response to TRH and vice versa occurred in some patients. It is not possible to predict by means of the TRH test the subsequent clinical course of patients in remission following antithyroid drug therapy.

Adult↗
PubMed1979

Studies of the TSH radioreceptor assay.

We have examined several variables in the reagents and procedures used in the TSH radioreceptor assay, the binding of iodinated TSH to its thyroidal receptor. We found that iodinated bovine TSH (S.A. 30 U/mg) was more effectively bound to receptor than iodinated human TSH (S.A. 7.3 U/mg). Iodination of TSH was the Bolton-Hunter acylation method apparently prevented binding to TSH receptor. Surgically removed human thyroid tissue specifically bound 10.3 +/- 1.0 (mean +/- SEM) of added [125I]TSH, but post-mortem human thyroid bound only 3.9 +/- 0.4% of [125I]TSH (p less than 0.001). Maximal binding of [125I]TSH was found at pH 5.8. Many tissue preparations contained activity, possibly due to proteases, which inactivated TSH, and inclusion of a protease inhibitor, aprotinin, significantly increased specific binding.

Animals↗
PubMed1979

Primary hypothyroidism preceding thyrotoxicosis: a report of 2 cases and a review of the literature.

Two cases are reported in whom primary hypothyroidism preceded thyrotoxic Graves' disease. The hypothesis is advanced that this sequence of events was mediated by spontaneous changes in the patient's autoimmune reactions to thyroid. In particular, it may reflect a spontaneous alteration in the balance between blocking antibodies reactive at or near the TSH receptor or cytotoxic thyroid autoimmune mechanisms on the one hand, and thyroid stimulating autoantibodies on the other.

Antibodies↗
PubMed1979

The value of islet cell antibody in predicting secondary failure of oral hypoglycaemic agent therapy in Diabetes mellitus.

The sera of 160 diabetics who were well controlled by oral hypoglycaemic agents (OHA) for at least three months after diagnosis were tested for pancreatic islet cell antibodies (ICAb) either at diagnosis or within two years after diagnosis. 129 were non-obese at diagnosis and of these ICAb was detected in the sera in 20 (16%). 31 were obese at diagnosis and of these ICAb was detected in the sera in three (10%). All of the 160 diabetics were insulin independent at the time of testing the serum for ICAb. The presence of ICAb was associated with a high probability of becoming insulin dependent, calculated from actuarial statistics. 86% of ICAb positive patients initially controlled on OHA may be expected to be insulin dependent at five years from diagnosis as compared to 18% of ICAb negative patients. Obesity at diagnosis did not significantly affect the probability of becoming insulin dependent. ICAb positive diabetes controlled by OHA can be regarded as a less severe form of insulin-dependent (Type I) diabetes.

Administration, Oral↗
PubMed1978

How often should patients be reviewed after treatment with iodine-131 for thyrotoxicosis?

Six to 18 years after treatment with iodine-131 for thyrotoxicosis 69 euthyroid patients with raised serum thyrotrophin (TSH) concentrations (mean 25.0 +/- SE 2.0 mU/l) and 61 with normal concentrations (mean 4.0 +/- 0.2 mU/l) were included in a prospective five-year follow-up study beginning in 1972. During this period 13 patients from the original group with raised serum TSH concentrations became hypothyroid. In contrast it was five years before hypothyroidism developed in a single patient from the group with normal serum TSH concentrations in 1972, although raised concentrations were recorded in 19 of these patients during the study.

Aged↗
PubMed1978

Thyroid function after surgical treatment of thyrotoxicosis. A report of 100 cases treated with propranolol before operation.

We assessed thyroid function for 12 months after subtotal thyroidectomy in 100 tyrotoxic patients treated with propranolol alone before and immediately after operation. The operation proved safe, with low morbidity. Suppression of the hypothalamic-pituitary-thyroid axis, present in the majority one month after operation, was evidenced by normal or low levels of serum total tri-iodothyronine and thyroxine, but absent or subnormal serum thyrotropin response to thyrotropin-releasing hormone. Eighty patients were euthyroid at 12 months. Three patterns of thyroid function were observed in this group between the first and 12th months: normal serum total tri-iodothyronine, thyroxine and thyrotropin levels at all stages (20 patients); normal serum total tri-iodothyronine and thyroxine, but raised thyrotropin levels on one or more occasions (40 patients); and temporary hypothyroidism (20 patients). Of the remaining 20 patients, permanent hypothyroidism developed in 14, and six relapsed. Postoperative thyroid function was related to the estimated weight of the thyroid remnant.

Adult↗
PubMed1978

Immune complexes in newly diagnosed insulin-dependent (type I) diabetics.

Soluble immune complexes (AgAb) and islet cell antibodies (ICAb) were studied in 110 insulin dependent diabetics (IDD) within a week of diagnosis and in about a third of the patients after 1, 3, 6 and 12 months. AgAb were studied by the solid phase Clq binding test in all the patients and also by the Raji cell radioimmunoassay in 52 sera at diagnosis. Diabetics at diagnosis showed a significantly higher incidence of AgAb in comparison with the control population. AgAb positivity declined with increasing time from diagnosis to reach the normal range within 3 months. Both the Clq and the Raji methods revealed a significant correlation at diagnosis between the occurrence at AgAb and the presence of ICAb. The possibility exists that AgAb, perhaps comprised of pancreatic antigen and ICAb, may be involved in the pathogenesis of type I diabetes.

Antibodies↗
PubMed1978

HLA in primary atrophic hypothyroidism and Hashimoto goitre.

The prevalence of HLA-B8 was found to be significantly increased in patients with primary atrophic (no goitre) hypothyroidism, but not in goitrous patients with Hashimoto thyroiditis, whether euthroid or hypothroid. There was no correlation between the occurrence of HLA-B8 and the presence of titres of thyroid antibodies at diagnosis or their persistence for at least three years after diagnosis.

Adult↗
PubMed1978

Immune complexes and diabetic microangiopathy.

Soluble immune complexes (AgAb) as detected and quantitated by the solid phase Clq assay (Clq-SP) were found to be increased in (a) long-duration diabetics with proliferative retinopathy and (b) short duration diabetics with early onset of retinopathy irrespective of whether they were treated with insulin or oral hypoglycaemic agents (OHA), in comparison to a normal population. No such increases were observed in diabetics of comparable duration without retinopathy. The trend for long-term diabetics to show an increased prevalence of AgAb according to the severity of retinopathy was statistically significant. Detection and quantitation of AgAb by the Raji cell assay (RAJI) gave comparable results although the differences were less pronounced and fell short of statistical significance. AgAb as detected by either method in insulin-treated diabetics could not be correlated with insulin antibodies. These findings suggest that AgAb, not necessarily comprised of insulin and anti-insulin antibodies, may contribute to the pathogenesis of diabetic microangiopathy.

Antibodies↗
PubMed1977

Correlation of HLA and thyroid antibodies with clinical course of thyrotoxicosis treated with antithyroid drugs.

The prevalence of HLA-B8 in thyrotoxic (Graves' disease) patients who relapsed after withdrawal of antithyroid drugs was high (69%) compared with that in patients who remained in remission (40%) and in healthy controls (28%). B8-positive patients were 1-8 times more likely to relapse after withdrawal of drug therapy than B8-negative patients. The persistence of thyroid microsomal antibodies after withdrawal of therapy correlated significantly with the presence of HLA-B8. This association was more pronounced in patients who remained in remission. From this it might be assumed that B8 is also associated with the persistence of thyroid T.S.H. (thyroid-stimulating hormone) receptor stimulating antibodies. In view of these findings, it is suggested that patients who are thyrotoxic might be typed for HLA, and those who are B8-negative could be given a trial of long-term antithyroid drug therapy.

Adolescent↗
PubMed1977

Familial studies of type-I and type-II idiopathic diabetes mellitus.

A study of 296 diabetics demonstrated an association between the type of diabetes in the propositi and their first-degree relatives (aged 40 to 89 yr), the type of diabetes being defined as insulin-dependent (type I) or insulin-independent (type II). This association was significant at the 1% level and was still maintained when only the propositi in whom the diabetes was diagnosed at the age of 30 years or later were considered. The findings also suggest that there is a greater genetic independence between these two types than was previously supposed and that the disease should be subdivided into type according to the treatment needed rather than by the age of onset.

Administration, Oral↗
PubMed1977

Spectrum of thyroid function in patient's remaining in remission after antithyroid drug therapy for thyrotoxicosis.

Thyroid function was assessed in 110 patients who were in remission for a period of 7-6 +/- 0-6 years (mean +/- S.E.) (range 0-25--25 years) after the withdrawal of antithyroid drug therapy for thyrotoxicosis. On the basis of clinical examination and on the results of thyroid-function tests, the following group of patients were identified: (I) euthyroid with normal plasma-total thyroxine (T4) and triiodothyronine (T3) concentrations, but an absent or subnormal response of plasma-thyrotrophin (T.S.H.) to thyrotrophin-releasing hormone (T.R.H.) (16%); (II) euthyroid with normal concentrations of plasma total T4 and T3 and a normal plasma-T.S.H. response to T.R.H. (59%); (III) euthyroid with normal concentrations of circulating thyroid hormones and a normal basal plasma-T.S.H., but an exaggerated plasma-T.S.H. response to T.R.H. (13%); (IV) euthyroid with normal plasma total T4 and T3 concentrations, but a raised basal plasma-T.S.H. concentration and an exaggerated plasma-T.S.H. response to T.R.H. (6%); (V) hypothyroid (6%). Although the need for short-term follow-up to identify those patients treated with antithyroid drugs who will relapse is well recognised, 16% of all patients in remission for longer than 4 years (10-8 +/- 0-7 years) in the present study showed some degree of thyroid failure. Evidence of hypothyroidism was associated with an increased frequency of thyroid microsomal antibodies. If the morbidity of the late development of hypothyroidism is to be avoided, patients who have been treated with antithyroid drugs should have long-term follow-up, as do patients treated surgically or with radioiodine.

Antithyroid Agents↗