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Abstract
The relevance of the study is due to both the growing number of autoimmune thyroid diseases and the aspects of the pathogenesis that have not been fully elucidated. The aim was to study immune indicators (antibodies to thyroperoxidase, TPOA) and total/the thyroidstimulating hormone receptor (TRAb) were performed by the chemiluminescent immunoassay on the Cobas 411 analyzer, Roche Diagnostics GmbH (Germany). The content of thyroidstimulating hormone (TSH), free thyroxine (fT4), free triiodothyronine (fT3), total/stimulating TRAb and TPOA were determined. The results. In patients with GD, regardless of the presence of TAO, TPOA levels before the start of treatment signifi cantly exceed the values of the comparison group (patients with toxic adenoma (274.00±43.70 IU/mL vs. 10.04±1.23 IU/mL; p<0.05) and do not change during antithyroid therapy. Levels of TRAb also signifi cantly exceed those of the comparison group (10.41±0.80 IU/L vs. 0.54±0.07 IU/L; p<0.05) and decrease only in 6 months after the start of antithyroid therapy, in 60.96% of patients, regardless of the presence/absence of TAO, their level stabilizes in the future, which is confi rmed by the control results 12 months after the start of treatment. Conclusions. 1. In patients with GD, regardless of the presence of TAO, TPOA levels before treatment signifi cantly exceed the values of the comparison group (patients with toxic adenoma) and do not change during antithyroid therapy. 2. TRAb levels in patients with GD signifi cantly exceed the values of the comparison group (patients with toxic adenoma) and decrease in 6 months after starting antithyroid therapy. In the future, their level stabilizes, which is confi rmed by monitoring 12 months after the start of treatment. 3. No diff erences were found in the levels of antithyroid antibodies (TPOA and TRAbs) in patients with GD depending on the presence of TAO. It was established that the levels of TPOA and TRAbs gradually decrease after thyroidectomy, signifi cant changes are recorded already during control 6 months after surgical intervention and reach the level of normal reference values 36 months after it. It has been proven that TRAb level in patients with TAO in 6 months after thyroidectomy decreases by 2 times (p<0.05), after 12 months – by 2.8 times (p<0.05), after 24 months, a decrease in TRAb level was recorded by 30 times, and the obtained result does not differ from the level of the control group of patients with toxic adenoma. A decrease in the activity of the autoimmune process led to the regression of clinical symptoms of TAO in 14.3% of cases. The obtained results should be taken into account when planning drug treatment of patients with TAO after thyroidectomy.
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