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Thyrotropin Receptor Autoantibodies in differential diagnosis of hyperthyroidism in children

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There was investigation carried out in group of 54 children (42 females and 12 males) aged between 10.3 and 17.2 years (median - 13. years) for the purpose of the estimation of the clinical significance determination of the general autoantibodies to the TSH recepetor (TBII) in differential diagnostics hyperthyroidism. In 45 from 54 cases (83.3 %) there was Graves’ disease (GD) diagnosis set, while high level of TBII was detected amongst 44 from those children (97.8%). Amongst patients with subacute thyroiditis and uninodal toxic goiter together with 7 children, initially estimated by us as “AIT, hyperthyroidism” the values TBII were in limit of reference interval. But for all of that unexpectedly there was detected normal level of Ab-TPO amongst all patients in this group, and - normal echogenic in 6 from 7 cases. From the one hand, high level of Ab-TG and heterogeneous structure may be estimated as particular qualities of hyperthyroidism clinical course during AIT by amongst children. However, absence of the row of diagnostic signs with long-lasting euthyroid condition do not allow us to estimate that cases as hyperthyroidism phase of AIT. From the other hand, we can suppose that we observe the diagnostic of natural clinical course of GD cases in phase of immunological remission. The detection of normal level of TBII in absence of typical clinical signs of GD amongst children with manifestation of hyperthyroidism let us retreat from active therapeutic intervention and choose the method of dynamic observation.

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