Serum Thyroglobulin Changes in Patients with Graves’ Disease Treated withLong Term Antithyroid Drug Therapy

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Abstract
In 29 patients with thyrotoxic Graves’ diseasetreated with conventional long term antithyroid drug therapy,serum thyroglobulin (Tg) was serially determined by RIA andcompared with clinical course, goiter shrinkage, and 131I uptakesuppression. Those subjects with Tg autoantibody-negative seracomprised 46% of the patients with Gravesdisease. They weredivided into a remission group (G I) and an exacerbation group(G II). G I was subdivided into G la, who were in remission for 7–40 months, and G Ib, who relapsed more than 15 months aftertherapy. G II was still on therapy 27–62 months after its initiation,because these subject exacerbated on reduction of thedrugs. Goiter shrinkage occurred in 60% and 0%, and 131I uptakeswere suppressed by T3 in 50% and 0% in G I and G II, respectively. Serum Tg in G I declined progressively andreached 48±5 (±SE) ng/ml on discontinuation of therapy, in sharp contrastwith serum Tg in G II which remained high throughout (154 ±29 ng/ml at the last examination; P Ó0.001). Results of goitershrinkage,131I uptake suppressibility, and serum Tg levels weresimilar in G la and G Ib on cessation of therapy. Serum Tglevels less than 68 or more than 140 ng/ml on discontinuationof therapy were helpful in predicting the outcome of therapy. On the other hand, Tg levels were low and goiters were small insize in euthyroid Graves’ disease. Tg levels were not clearlycorrelated with goiter weight or serum T4 and Ta levels beforetreatment. In conclusion, serial determinations of serum Tg reflect thyroid activity and provide information useful in thedecision to discontinue therapy and observation after that. (J Clin EndocrinolMetab56: 507, 1983)

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