| Abstract [eng] |
Graves' disease is autoimmune thyroid disease caused by autoantibodies against the thyroid-stimulating hormone receptor. Genetic susceptibility in combination with environmental and/or endogenous factors is believed to initiate autoimmunity against antigens, expressed within the thyroid gland, and lead to the abnormalities in thyroid function. Although the genetic factors undoubtedly play an important role in the development of Graves' disease, there are substantial ethnic differences in Graves' disease genetic predisposition between populations. The main treatment strategies for Graves' disease include antithyroid drugs, thyroid ablation with radioiodine or surgery. Antithyroid drugs are effective in controlling hyperthyroidism. Unfortunately, 30 to 60% of patients relapse within 1 year of antithyroid drugs discontinuation. As current treatment of Graves' disease is often unsatisfactory, identification of prognostic parameters may help select patients who have high recurrence risk after medical therapy and recommend them an early thyroid ablation (thyroid ablation with radioiodine or surgery) in order to avoid long, useless and potentially harmful antithyroid drug therapy. The aim of the study was to determine the value of demographic, clinical and laboratory features, thyroid ultrasound pattern and genetic factors (CTLA-4 gene 49A/G and CT60 polymorphisms and thyroglobulin gene E33 C/T polymorphism) as predictors of medical treatment failure in patients with Graves' disease. Our findings should help to improve the treatment planning process in the clinical practice. |
