Endocrine Abstracts

Introduction: The choice of treatment for Graves’ disease (GD) requires a comprehensive assessment of the patient’s condition and the risk of recurrence. The aim of our study was to evaluate the association of immunological and genetic markers with GD recurrence after antithyroid treatment.

Methods: We conducted a case-control study. The study included 63 patients with GD who received antithyroid treatment. After at least 12 months of withdrawal patients were divided into two groups: 1. GD remission (n =18); 2. GD relapse (n =45). All patients have undergone a laboratory examination, the study of polymorphic markers of the CTLA4, TSHR genes was performed by polymerase chain reaction. Statistical analysis of the results was carried out using SPSS 26.0. A P value <0.05 was considered statistically significant.

Results: The level of TRAb at the time of discontinuation of therapy was significantly higher in the group with GD relapse - 5.05 [0.84; 24.08] than in the group with GD remission – 1.0 [0.5; 1.88] (P =0.033). 37.9% of patients with GD relapse and 15.6% with GD remission had a hereditary predisposition to GD (P = 0.006). An active Graves’ ophthalmopathy (GO) was more common in the group with GD relapse - 23 (53.5%) than with GD remission - 14 (77.8%) (P = 0.025). Carriage of the GG genotype polymorphism of the TSHR gene was more frequent in patients with GD remission - 38.1% compared with patients with GD relapse - 10.3% (P = 0.009). There was not significant difference in polymorphic markers of the CTLA4 gene.

Conclusions: Several risk factors for relapse are identified. A higher level of TRAb, history of active GO, hereditary predisposition to GD are associated with relapse of GD. The result of our study shows association of TSHR gene polymorphism with GD remission after antithyroid treatment.