Thyroid Receptor Antibodies and Thyroid Peroxidase Antibodies in a Sample Thyrotoxic Patients: A Cross-Sectional Study

Abstract

Background: Thyrotoxicosis is a clinical status due to hypersecretion of thyroid hormones by diffuse goiter (Grave’s disease [GD]), multinodular goiter, single toxic adenoma, and pituitary adenoma secreting thyroid-stimulating hormone (TSH) rarely. GD: It is diffuse toxic goiter (GD) or (Basedow disease) it is a triad of: Diffuse toxic goiter, hyperthyroidism, and exophthalmos (proptosis). Aims: 1. Positivity of TRAb and TPO in thyrotoxic subjects. 2. Correlation of the titer of these antibodies with the clinical status of the patients. 3. Correlation between TRAb and TPO titer. 4. To find out if TPO titer on enrollment has any correlation with the clinical status of the patients. Methods: A cross-sectional study conducted in the National Diabetes Center–Mustansiriyah University in the period from November 2021 to April 2022 where 93 patients with GD are enrolled to check their thyroid status and check some biochemical variables in their sera as thyrotropin receptor antibody (TRAB), thyroid peroxidase (TPO) antibody, TSH, and free thyroxine (FT4). 44.6% are women and 35.7% are men, at the time of recreuitment 49.4% are toxic while the remaining 58.6% are euthyroid being on anti thyroid drugs. 87 persons are recruited as normal euthyroid, they are sex and age-matched, the control TRAb were negative. Results: GD patients are as follows: 54 (58.06%) euthyroid and 39 (41.94%) toxic at the time of recruitment. Eighty-two percent of toxic patients have goiter and 74.07% of euthyroid GD patients have goiter. Ophthalmopathy is found in (64.1% of toxic GD patients and 42.59% of euthyroid GD patients. TPO median in the control, toxic, and euthyroid GD patients is (22.76%), (75%) and (63.5%) (highest among toxic GD patients) (P < 0.001). TSH in the control group has a mean of (2.18 ± 1.72) and a median of (1.89). The TRAb is the highest in toxic GD patients, followed by euthyroid GD patients and the least in the control, its mean is (9.98 ± 8.42), (7.24 ± 7.8) and (0.93 ± 0.15), respectively. It is recommended to conduct a longitudinal study in which patients with GD are checked at variables times in the course of illness (remission and relapse) studying these biochemical and immunological markers in these variable states of thyroid function. Conclusion: Ninety-three thyrotoxic patients, 39 are toxic and 54 are euthyroid on arrival. Eye sings are more in toxic patients, goiter and eye signs are predictor of GD, TRAb is the highest among toxic patients, TPO are higher among GD patients versus the control.