Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2009 Oct;32(10):1817-9.
doi: 10.2337/dc08-2339. Epub 2009 Jun 23.

Graves hyperthyroidism after stopping immunosuppressive therapy in type 1 diabetic Islet cell recipients with pretransplant TPO autoantibodies

Pieter Gillard  1 , Volkert Huurman, Bart Van der Auwera, Brigitte Decallonne, Kris Poppe, Bart O Roep, Frans Gorus, Chantal Mathieu, Daniel Pipeleers, Bart Keymeulen
Affiliations

Graves hyperthyroidism after stopping immunosuppressive therapy in type 1 diabetic Islet cell recipients with pretransplant TPO autoantibodies

Pieter Gillard et al. Diabetes Care. 2009 Oct.

Abstract

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.

PubMed Disclaimer

References

    1. Shapiro AM, Ricordi C, Hering BJ, Auchincloss H, Lindblad R, Robertson RP, Secchi A, Brendel MD, Berney T, Brennan DC, Cagliero E, Alejandro R, Ryan EA, DiMercurio B, Morel P, Polonsky KS, Reems JA, Bretzel RG, Bertuzzi F, Froud T, Kandaswamy R, Sutherland DE, Eisenbarth G, Segal M, Preiksaitis J, Korbutt GS, Barton FB, Viviano L, Seyfert-Margolis V, Bluestone J, Lakey JR: International trial of the Edmonton protocol for islet transplantation. N Engl J Med 2006; 355: 1318– 1330 - PubMed
    1. Keymeulen B, Gillard P, Mathieu C, Movahedi B, Maleux G, Delvaux G, Ysebaert D, Roep B, Vandemeulebroucke E, Marichal M, In 't Veld P, Bogdani M, Hendrieckx C, Gorus F, Ling Z, van Rood J, Pipeleers D: Correlation between beta cell mass and glycemic control in type 1 diabetic recipients of islet cell graft. Proc Natl Acad Sci U S A 2006; 103: 17444– 17449 - PMC - PubMed
    1. Heimberg H, Nagy ZP, Somers G, De Leeuw I, Schuit FC: Complementation of HLA-DQA and -DQB genes confers susceptibility and protection to insulin-dependent diabetes mellitus. Hum Immunol 1992; 33: 10– 17 - PubMed
    1. Jacobson EM, Tomer Y: The genetic basis of thyroid autoimmunity. Thyroid 2007; 17: 949– 961 - PubMed
    1. Van Bockstaele DR, Deneys V, Philippé J, Bernier M, Kestens L, Chatelain B, De Waele M, Demanet C: Belgian consensus recommendations for flow cytometric immunophenotyping: the Belgian Association for Cytometry/Belgische Vereniging voor Cytometrie/Association Belge de Cytométrie. Acta Clin Belg 1999; 54: 88– 98 - PubMed

Publication types