Comparison of Thyroid Stimulating Hormone Receptor Antibody (TRAb) in Graves’ Disease Patients with and Without Ophtalmopathy

Background: Ophthalmopathy Graves’ is one of the serious complications of Graves’ diseases, that can decrease the quality of life of the patient. The pathogenesis is not well understood, resulting in less effective therapy and resulting in permanent eye function impairment. Objective: To determine the ratio of thyroid stimulating hormone receptor antibody (TRAb) between Graves’ disease patients with and without ophtalmopaty. Methods: This is a cross-sectional study involving 50 patients with Graves’ active disease, who underwent treatment at Endocrine and Metabolic Unit of Internal Disease, Outpatient Installation of Dr. Soetomo General Hospital Surabaya. Graves’ ophthalmopathy was determined when extracted eksoftalmus or eyelid retraction with thyroid dysfunction was found. Levels of thyroid-stimulating hormone (TSH) and FT4 were measured using the ELISA method. Meanwhile, TRAb level was measured using third generation thyroid binding inhibiting immunoglobulins (TBII) with ELISA method. Results: There were 25 (50%) patients in the active Graves’ patient group with and without ophthalmopathy, respectively, with age ranging from 20 to 65 years old. The median value of TRAb patients with Graves ‘disease with ophthalmopathy was 3.21 IU/l, which is higher and statistically significant (p = 0.001) than TRAb levels of patients with Graves’ disease without ophthalmopathy, with median value of 1.81 IU/l. Conclusion: Higher levels of TRAb were found and statistically significant in Graves ‘disease patients with ophthalmopathy than Graves’ patients without ophthalmopathy.