IgE and thyrotropin receptor antibodies : a probable link between graves’ thyrotoxicosis and atopy

Abstract EN

Both serum total IgE and thyrotropin receptor antibodies (TRAb) were assessed in patients with atopy and Graves'disease with and without ophthalmopathy.

30patients with newly or recently diagnosed Graves’ disease were included in this research with a mean age of 27.7years (range 17-45 years).

Graves’ ophthalmopathy was present in 13 patients.

All patients were either not given or just given antithyroid drugs, yet still uncontrolled.

A third group of patients with atopic rhinitis or bronchial asthma was involved too.

All were positive for skin tests for one or more of the common environmental antigen.

They were 22 patients and matching the Graves’patients for age and sex.

All the studied patients were recruited at Ain Shams University hospitals and were currently on neither corticosteroid nor antihistamine drug therapy.

Both IgE and TRAb were elevated in the studied groups, yet IgE was highly significantly higher in the atopic patients in relation to Graves’ patients (P < 0.001).

For TRAb, the reverse was correct i.e.

a highly significantly higher value of TRAB in Graves’ patients compared with atopic patients (P < 0.001).

A significantly higher incidence of the elevated IgE; was present among patients with Graves’ ophthalmopathy when compared with those without ophthalmopathy [46% (6/13) vs.

23% (4/17), respectively, P < 0.05].

Meanwhile, there was insignificant difference in this relation as regard TRAb [70% (9/13) vs.

65% (11/17), for Graves’patients with and without ophthalmopathy, respectively, P > 0.05J.

In atopic patients, the incidence of elevated IgE was 68% and elevated TR was 27% (15 & 6/22patients, respectively).

We found a positive correlation between IgE and TRAb among patients with Graves’ disease (r = 0.7891, P < 0.01) and not among atopic patients (r = 0.1822, P> 0.05).

In conclusion, total serum IgE is elevated in Graves’thyrotoxicosis in parallel with TRAb, particularly in the presence of ophthalmopathy, suggesting its participation in the pathogenesis of the disease.

On the other hand, although TRAb is elevated in atopy, it does not correlate with IgE, and it seems to be rather a marker of autoimmunity.

To support these findings and also, to assess antihistaminic effect as well as TRAb suppression in the management of Graves’ disease and atopy, respectively, are requested in the future.