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Primary Myxedema with Thyrotrophin-Binding Inhibitor Immunoglobulins: Clinical and Laboratory Findings in 15 Patients

KONISHI JUNJI, M.D.; YASUHIRO IIDA, M.D.; KANJI KASAGI, M.D.; TAKASHI MISAKI, M.D.; TETSUO NAKASHIMA, M.D.; KEIGO ENDO, M.D.; TORU MORI, M.D.; SHINICHIRO SHINPO, M.D.; YACHIYO NOHARA, M.D.; NOBUO MATSUURA, M.D.; and KANJI TORIZUKA, M.D.
[+] Article and Author Information

Grant support: by grant 58570998 from the Ministry of Education, Science and Culture; and a Research Grant for Intractable Disease from the Ministry of Health and Welfare, Japan.

▸Requests for reprints should be addressed to Junji Konishi, M.D.; Department of Nuclear Medicine, Kyoto University School of Medicine; Sakyo-ku, Kyoto 606, Japan.


Kyoto and Sapporo, Japan


© 1985 American College of PhysiciansAmerican College of Physicians


Ann Intern Med. 1985;103(1):26-31. doi:10.7326/0003-4819-103-1-26
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In a screening of 43 patients with primary myxedema, 9 patients were found to have IgG that inhibits the binding of 125I-thyrotrophin to its receptor (thyrotrophin-binding inhibitor immunoglobulins). Preparations of IgG from these patients did not stimulate thyroidal cyclic adenosine monophosphate generation and blocked thyroid stimulation by thyrotrophin in vitro. Clinical and laboratory features of 15 patients with this inhibitor, including 6 who were previously known, were compared with those of patients without the inhibitor. The patients with inhibitor, 2 men and 13 women, had onset of their hypothyroidism from age 2 to 49 years, and thyroid uptake in these patients was significantly lower than that in patients without inhibitor. Transient hypothyroidism was seen in all 5 infants born to 4 mothers having potent inhibitor immunoglobulins. These clinical findings indicate that thyrotrophin-receptor-blocking antibodies play a pathogenic role in a group of patients with primary myxedema.

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