Epidemiology of thyroid-stimulating immunoglobulin in recent-onset symptomatic thyroid eye disease
Authors' conclusion
TSI can be a serum biomarker for the diagnosis, prognosis, and treatment response of TED. Further validation should be warranted.
Study context
- Population
- Treatment-naive patients with recent-onset symptomatic thyroid eye disease (TED), Chinese University of Hong Kong, January 2014 to May 2022; 197 female, mean onset age 50 ± 14 yearstreatment-naive
- Participants
- 255 patients
- Outcome
- Correlations between TSI and clinical (CAS, MRD1, EOMy, exophthalmos, diplopia) and radiological (STIR MRI extraocular muscle area and signal) parameters
Methodological detailssingle-centre
- Single-centre
Main finding
As reported in the abstract
Elevated pre-treatment thyroid-stimulating immunoglobulin (TSI)
223
88%
Correlation TSI vs Clinical Activity Score (CAS) (weak positive)
r = 0.28
P = 0.000031
Correlation TSI vs marginal reflex distance1 (MRD1) (weak positive)
r = 0.17
P = 0.0080
Correlation TSI vs size of levator palpebrae superioris/superior rectus complex (weak positive)
r = 0.25
P = 0.018
Observational data: associations, not effects.
Further findings
Diagnostic performance of TSI for clinically active TED
- AUC
- 0.67 (95% CI: 0.60-0.75)
- Optimal cut-off
- 284%
- Specificity
- 50%
- Sensitivity
- 85%
Baseline TSI in patients receiving intravenous methylprednisolone (IVMP) vs not
- Patients receiving IVMP during study
- 64
- Higher baseline TSI with IVMP vs without
- P = 0.000044
Serial post-IVMP TSI vs baseline
- Significant TSI reduction vs baseline among 62 patients
- P < 0.001
TSI by response to first IVMP course
- Baseline and post-IVMP TSI and % TSI changes comparable between responders and non-responders
Original publication
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