IDENTIFICATION OF SUBSETS OF PATIENTS WITH GRAVES’DISEASE BY CLUSTER ANALYSIS

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Abstract
SUMMARY: We have applied cluster analysis methods to forty‐nine laboratory and clinical characteristics (including 26 HLA‐A, B antigens) observed in 196 Graves’disease patients. Three subgroups could be identified: group I (seventy‐nine patients) had small goitres, low indices of autoimmunity and a tendency to remission with medical treatment; group IIa (twenty‐nine patients) had clinical and laboratory features of‘Hashitoxicosis'; Group IIb (eighty‐four patients) had a high incidence of ophthalmopathy, familial aggregation, marked evidence of autoaggression and a tendency to relapsing hyperthyroidism. The prevalence of HLA‐B8 was 8.9% in group I, 20.7% in group IIa and 86.9% in group IIb. This study demonstrates that Graves’disease can be subdivided using cluster analysis into clinically relevant subgroups which are further distinguished by their correlation with HLA‐B8. Possible immunological bases for these observed patterns are discussed.