Antineutrophil and antinuclear antibodies in patients with hyperthyroidism caused by Graves' disease

(July 2003)

The background of the study. Antibodies that react with white blood cells (neutrophils) are associated with inflammation of blood vessels and kidney disease, and antibodies that react with cell nuclei are associated with systemic lupus erythematosus. Both antibodies have been found in patients with hyperthyroidism caused by Graves' disease, the strongest association being between antineutrophil and propylthiouracil therapy. In this study, serum antineutrophil and antinuclear antibodies were measured in patients with Graves' hyperthyroidism before and during methimazole therapy.

How the study was done. The study subjects were 30 patients with hyperthyroidism caused by Graves' disease. Serum antineutrophil antibodies and antinuclear antibodies were measured before and periodically during therapy.

The results of the study. Before therapy, antineutrophil antibodies were detected in the serum of 50 percent of the patients. There was no correlation between the levels of these antibodies and antithyroid peroxidase, antithyroglobulin, or TSH-receptor antibodies. During methimazole therapy, the antineutrophil antibodies disappeared in six patients and appeared in one patient. Before therapy, antinuclear antibodies were detected in the serum of 73 percent of the patients. There was no change in these antibodies titers during therapy. No patient had blood-vessel inflammation at any time.

The conclusions of the study. Patients with Graves' hyperthyroidism may have antineutrophil antibodies, which may disappear during antithyroid drug treatment, and antinuclear antibodies, which do not change during therapy.

The original article. Guma M, Salinas I, Reverter JL, Roca J, Valls-Roc M, Juan M, Olive A. Frequency of antineutrophil cytoplasmic antibody in Graves' disease patients treated with methimazole. J Clin Endocrinol Metab 2003;88:2141-6.