期刊
DIABETES CARE
卷 32, 期 10, 页码 1817-1819出版社
AMER DIABETES ASSOC
DOI: 10.2337/dc08-2339
关键词
-
资金
- Juvenile Diabetes Research Foundation [4-2001-434]
- Belgium Program on Interuniversity Poles of Attraction initiated by the Belgian State [1AP P5/17]
- Fund for Scientific Research-Flanders (FWO)
OBJECTIVE - After an initially successful islet cell transplantation, a number of patients return to C-peptide negativity, and therefore immunosuppressive therapy is discontinued. Some are then found to have developed Graves disease. We examined the risk of Graves disease after immunosuppression. RESEARCH DESIGN AND METHODS - Immunosuppressive therapy was stopped in 13 type 1 diabetic islet cell recipients who had received one course of antithymocyte globulin and maintenance doses of mycophenolate mofetil and a calcineurin inhibitor. None had a history of thyroid disease. RESULTS - In four patients, clinical Graves hyperthyroidism was observed within 21 months after discontinuation and 30-71 months after the start of immunosuppressive therapy. All four patients exhibited a pretransplant positivity for thyroid peroxidase (TPO) autoantibodies, while the nine others were TPO negative pre- and posttransplantation. CONCLUSIONS - Type 1 diabetic recipients of islet cell grafts with pretransplant TPO autoantibody positivity exhibit a high risk for developing Graves hyperthyroidism after immunosuppressive therapy is discontinued for a failing graft.
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