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  • Anonymous
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    If you look at the names of the authors Dr. JR Wall is the last one on the list of names. He is on our board of medical advisiors.

    Jake
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    Anonymous
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    J Clin Endocrinol Metab 1999 Apr;84(4):1255-62

    Serum antibodies against the flavoprotein subunit of
    succinate dehydrogenase are sensitive markers of eye muscle
    autoimmunity in patients with Graves’ hyperthyroidism.

    Gunji K, De Bellis A, Kubota S, Swanson J, Wengrowicz S, Cochran B, Ackrell BA, Salvi M,
    Bellastella A, Bizzarro A, Sinisi AA, Wall JR

    Department of Medicine, Allegheny University Hospitals, Allegheny General, Pittsburgh,
    Pennsylvania 15212-4772, USA.

    Thyroid-associated ophthalmopathy is an autoimmune disorder of the extraocular muscles and
    orbital connective tissue, which is usually associated with Graves’ hyperthyroidism.
    Well-studied markers of ophthalmopathy are eye muscle membrane antigens, reportedly of
    approximately 64-kDa molecular mass. One, originally identified only as the 64-kDa protein,
    has recently been shown to be the flavoprotein (Fp) subunit of mitochondrial succinate
    dehydrogenase, which has a correct molecular mass of 67 kDa. We have used purified beef
    heart Fp as antigen in an enzyme-linked immunosorbent assay for cross-reactive human
    autoantibodies. Sera have been screened from patients with thyroid-associated ophthalmopathy
    classified according to activity and presence or not of eye muscle disease, and from those with
    Graves’ hyperthyroidism without eye involvement. Also examined were serum samples taken
    periodically from 20 patients with Graves’ hyperthyroidism during 24 months of treatment of
    their hyperthyroidism with antithyroid drugs. Four of these patients had ophthalmopathy at the
    onset, 12 developed ophthalmopathy, and 4 did not develop any eye signs during treatment.
    Anti-Fp subunit antibodies were detected in 73% of patients with active ophthalmopathy and
    evidence of eye muscle involvement but only in 25% if there was only congestive
    ophthalmopathy. These values were 0% and 11% for patients with chronic ophthalmopathy,
    with or without eye muscle dysfunction, respectively. The antibodies were also detected in
    14% of patients with Graves’ hyperthyroidism without evident ophthalmopathy, 11% of patients
    with nonimmunologic thyroid disorders, 12% of type I diabetics, and 12% of age- and
    sex-matched normal subjects. Significantly, appearance of anti-Fp antibodies predicted the
    development of ophthalmopathy in 5 of the 6 patients with Graves’ hyperthyroidism, who
    developed eye muscle dysfunction after treatment of the hyperthyroidism, and coincided with
    the onset of eye muscle signs in the other patient. Antibodies were not detected in any of 6
    patients who developed congestive ophthalmopathy without evidence of eye muscle damage or
    in 4 patients who did not develop any eye signs. In conclusion, we have shown a close
    relationship between eye muscle disease and serum antibodies against the Fp subunit of
    succinate dehydrogenase in patients with Graves’ hyperthyroidism.

    PMID: 10199764, UI: 99213856

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