A reconsideration of a thyroid-stimulating immunoglobulin as the cause of hyperthyroidism in Graves' disease

• Published in: The journal of clinical endocrinology and metabolism Vol. 42; no. 4; p. 778
• Main Authors: McKenzie, J M, Zakarija, M
• Format: Journal Article
• Language: English
• Published: United States 01.04.1976
• Subjects: Animals; Cyclic AMP - metabolism; Graves Disease - complications; Graves Disease - immunology; Graves Disease - metabolism; Humans; Hyperthyroidism - etiology; Hyperthyroidism - immunology; Hyperthyroidism - metabolism; Immunoglobulin G; Immunoglobulins - metabolism; Long-Acting Thyroid Stimulator; Mice; Thyroid Gland - metabolism; Thyroid Gland - physiopathology
• ISSN: 0021-972X
• DOI: 10.1210/jcem-42-4-778

Several assays for thyroid-stimulating immunoglobulins in the blood in patients with Graves' disease have been described recently; depending upon the method, different names have been used and distinct entities thus implied. Using an increase in cyclic AMP in the human thyroid slice after 2 h of incubation as an index of thyroid stimulation, we identified thyroid-stimulating activity in all of an unselected series of sera from 11 patients with hyperthyroidism of Graves' disease, but long-acting thyroid stimulator, by mouse bioassay, in only three. The theory is proposed that the thyroid-stimulating immunoglobulin is probably present in all such patients; it may be seen as a polyclonal antibody to a single human antigen that has a variable cross-reaction with a corresponding thyroid antigen in the mouse and in other species.