Submitted: 14 Apr 2020
Accepted: 27 Jun 2020
ePublished: 17 Jul 2020
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Immunopathol Persa. 2021;7(1): e06.
doi: 10.34172/ipp.2021.06
  Abstract View: 509
  PDF Download: 289


Clinical and biochemical aspects between “stress” and “non-stress” induced Graves’ disease

Mostafa Najafipour 1,2 ORCID logo, Masoumeh Zareizadeh 3 ORCID logo, Farzad Najafipour 3,4 ORCID logo

1 Young Researchers and Elite Club, Ardabil Branch, Islamic Azad University, Ardabil, Iran
2 Faculty of Medicine, Azad Ardabil University of Medical Sciences, Ardabil, Iran
3 Endocrine Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
4 Department of Internal Medicine, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran


Introduction: The role of stress in the pathogenesis of Graves’ disease has been highlighted in many studies. The hereditary pattern of Graves’ disease is uncertain because various genetic and environmental factors are known. One of the most important environmental factors is stress. Any kind of stress, such as physical and emotional, can flare or create Graves’ disease.

Objectives: The aim of this study was to evaluate the clinical and biochemical aspects of “stress-induced” and “non-stress induced” Graves’ disease.

Patients and Methods: This study evaluated 148 patients with Graves’s disease. According to perceived stress scale (PSS) all patients were divided into two groups; stress and non-stress induced Graves’ group. Chi-square test was used to determine statistical difference in qualitative variables.

Results: The mean ± standard deviation perceived stress scale score in 53 patients in stress induced Graves’ disease was 40.24±6.53 and in 95 patients in non-stress induced Graves’ disease was 18.47±3.90. In this study the onset of Graves’ disease is more severe in the stress induced Graves’ disease, however the level of antithyroid peroxidase was significantly lower. Duration of methimazole since diagnosis and doses of methimazole in the stress induced Graves’ group was shorter than non- stress induced Graves’ group (P<0.001 and 0.032 respectively) and percent of male was significantly higher in stress induced Graves’ group (P=0.002).

Conclusion: According to this study, clinical characteristics of stress induced Graves’ disease differ with non-stress induced Graves’ disease. Generally, severity of disease in stress induced Graves’ group was initially more severe (higher FT4 in this group), but duration of disease was shorter than non-stress induced Graves’ disease, and these patients had smaller size of goiter and lower anti-thyroid peroxidase (anti-TPO) antibody (anti-TOP Ab).

Keywords: Graves’ disease, Autoimmunity, Antithyroid peroxidase, Thyroid disease, Stress induced
Citation: Najafipour M, Zareizadeh M, Najafipour F. Clinical and biochemical aspects between “stress” and “non-stress” induced Graves’ disease. Immunopathol Persa. 2021;7(1):e06. DOI:10.34172/ipp.2021.06.
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Abstract View: 509

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