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No Increase of Blocking Type Anti-Thyrotropin Receptor Antibodies During Pregnancy in Patients with Graves’ Disease

Department of Laboratory Medicine (N.A., Y.I., Y.H., K.T., Y.N., K.-I.T., T.T.), Osaka University Graduate School of Medicine, Osaka 565-0871, Japan; and Diagnostic Department (A.N.), Yamasa Corporation, Tokyo 103-0014, Japan

Address all correspondence and requests for reprints to: Nobuyuki Amino, Department of Laboratory Medicine, Osaka University Graduate School of Medicine D2, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan. E-mail: namino{at}labo.med.osaka-u.ac.jp.

Serial changes in serum levels of anti-TSH receptor antibodies were examined during and after pregnancy in six patients with Graves’ disease receiving no or minimal maintenance doses of antithyroid drugs. During pregnancy, serum levels of TSH-binding inhibitory Igs (P < 0.001) and thyroid-stimulating antibodies (TSAbs) (P < 0.01) decreased gradually but increased after delivery in all patients. Activities of thyroid-stimulation blocking antibodies (TSBAbs) were lower than the cut-off value in early pregnancy, and values significantly decreased in four patients during pregnancy. The other two patients showed no significant change during pregnancy. In contrast, TSBAb levels increased significantly (P < 0.01) after delivery in all patients. We found that activities of TSH-binding inhibitory Igs, TSAb, and TSBAb decrease during pregnancy and increase after delivery, suggesting that amelioration of Graves’ disease during pregnancy is induced by decrease of TSAb but not by the appearance of TSBAb.

This work was supported by Grants-in-Aid for Scientific Research (14207107 and 15659135) (to N.A.) from the Ministry of Education, Culture, Sports, Science, and Technology of Japan and Health Science Grants from the Ministry of Health, Labor, and Welfare of Japan.

Abbreviations: CV, Coefficient of variation; MCHA, antithyroid microsomal antibody; TBII, TSH-binding inhibitory Ig; Th, T helper cell; TSAb, thyroid-stimulating antibody; TSBAb, thyroid-stimulation blocking antibody.

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