Predictive effect of persistent negative TRAb for relapse of
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The remission rate in children with Grave's disease (GD) after 2–6 years of antithyroid drug (ATD) treatment is 40–50%. It has been reported that it is difficult to predict the GD prognosis based on the TSH receptor antibody (TRAb) level at the cessation of ATD treatment. Researchers studied whether the persistence of negative TRAb at ATD treatment cessation increased the remission rate in pediatric patients with GD.

Researchers included 22 patients diagnosed with GD who discontinued ATD treatment after confirmation of negative TRAb on two or more consecutive tests. Remission was defined as the maintenance of normal thyroid function, including serum TSH level, with negative TRAb more than 2 years after ATD discontinuation.

Results:
--Of the 22 patients, 12 achieved remission (remission rate 54.5%), with no significant between-group difference in the median duration of ATD treatment in the remission and relapse groups (4.4 vs 3.9 years).

--Of the 10 patients who relapsed, 4 relapsed within 2 years after ATD discontinuation, and 4 relapsed more than 5 years after ATD discontinuation.

Finally, although the presence of negative TRAb at the end of ATD treatment may mean a longer period of remission, it does not increase the final remission rate in children with GD.

Source: https://onlinelibrary.wiley.com/doi/10.1111/ped.14749?af=R
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