RESUMO
Fifty patients with Graves' disease were evaluated in relation to their outcome following medical treatment: goiter size, T3/T4 ratio, TSH and TSAb plasma levels were studied. Patients were followed for 8-20 months of medical treatment with PTU and 24-36 months thereafter. Thirty patients were eliminated for abandoning treatment (50%) or due to PTU side-effects (10%). The 20 patients remaining presented similar remission/relapse rates regardless of their T3/T4 ratio, greater than 20 (21% vs. 79%) or less than 20 (16% vs. 84%). Patients with TSH levels greater than 0.10 uU/ml immediately after PTU withdrawal presented a slight increase of remission rate (30% vs. 10%). Patients with goiter size greater than 60 cm3 at the beginning of medical treatment presented a remission rate of 8%, while those with goiters less than or equal to 60 cm3 showed a remission rate of 50%. Finally, normalization of TSAb levels (less than 15%) occurred at a remission rate of 100%, while all patients who did not achieve this goal relapsed shortly after PTU withdrawal. Based on these results, the authors conclude that the determination of TSAb levels is a reliable parameter of predict remission of Graves' disease following medical treatment.