Distinction Between Autoimmune and Non-Autoimmune Hyperthyroidism by Determination of TSH-Receptor Antibodies in Patients with the Initial Diagnosis of Toxic Multinodular Goiter

2001 ◽  
Vol 33 (8) ◽  
pp. 504-507 ◽  
Author(s):  
H. Wallaschofski ◽  
C. Orda ◽  
P. Georgi ◽  
K. Miehle ◽  
R. Paschke
Keyword(s):  
Multinodular Goiter ◽  
Initial Diagnosis ◽  
Tsh Receptor ◽  
Toxic Multinodular Goiter ◽  
Receptor Antibodies ◽  
Tsh Receptor Antibodies

Recombinant TSH-Receptor for Determination of TSH-Receptor-Antibodies

2009 ◽  
Vol 100 (04/05) ◽  
pp. 73-74 ◽  
Author(s):  
M. Ludgate ◽  
S. Costagliola ◽  
D. Danguy ◽  
J. Perret ◽  
G. Vassart
Keyword(s):  
Tsh Receptor ◽  
Recombinant Tsh ◽  
Receptor Antibodies ◽  
Tsh Receptor Antibodies

scholarly journals SAT-415 Clinical Performance of Thyroid-Stimulating Immunoglobulin for Graves′ Disease Diagnosis

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Suemi Marui ◽  
Aline Lenczuk ◽  
Nelisa Helena Rocha ◽  
Tomoco Watanabe ◽  
Luciana Pinto Brito
Keyword(s):  
Multinodular Goiter ◽  
Clinical Performance ◽  
Graves Disease ◽  
Toxic Adenoma ◽  
Serum Samples ◽  
Toxic Multinodular Goiter ◽  
Analytical Range ◽  
Roche Diagnostics ◽  
Receptor Antibodies ◽  
Tsh Receptor Antibodies

Abstract INTRODUCTION The diagnosis of Graves′disease (GD) is likely when patient presents hyperthyroidism, symmetrical goiter and orbitopathy and further evaluation is unnecessary. Nevertheless patient with nodular thyroid or in the absence of clinical orbitopathy, measurement of TSH receptor antibodies (TRAb) is recommended to distinguish GD from toxic multinodular goiter, toxic adenoma and other etiologies. Radioiodine uptake (RAIU) also helps to diagnosis when TRAb is unavailable. Third generation TRAb assays measure all types of TSH receptor antibodies: stimulating, blocking and neutral with an excellent sensitivity and specificity for GD diagnosis. Recently, an automated bioassay for the thyroid stimulating immunoglobulin (TSI) was introduced to improve GD diagnosis. OBJECTIVE To analyze clinical performance of TSI and compare with TRAb assay for GD diagnosis. MATERIAL AND METHODS Serum samples of 117 patients with thyrotoxicosis due to GD, toxic multinodular goiter and toxic adenoma were runned simultaneously in two analytical system commercially available. TRAb was analyzed by Elecsys Anti-TSHR assay (Roche Diagnostics, Germany) in a Cobase411 analyzer (Roche Diagnostics, Germany) and results, according to the manufacturer interval reference, were negative if < 1.75 IU/L (analytical range: 0.3 to 40 IU/L). TSI was measured by Immulite TSI assay (Siemens Healthcare, UK) in Immulite XPi 2000 and results, according to the manufacturer interval reference, were negative if < 0.55 IU/L (analytical range: 0.1 to 40 IU/L). Clinical diagnoses of thyrotoxicosis were determined according to ATA guideline (2016). Statistical analyses were performed using SPSS and MedCalc softwares. Comparison were evaluated by regression equations and were considered significant when p values were < .05. RESULTS From 2017 to 2019 a total of 312 serum samples from 117 patients (96 females) were evaluated with mean age 49.5 ±15.8 years-old (18 to 90 yrs). We excluded 26 results above the analytical measurement range of both assays. A high degree correlation was observed with a slope of 0.647 and an intercept -.094 IU/L. Spearman correlation coefficient was 0.858 (p < 0.0001, 95% CI 0.825 to 0.886). TSI assay had higher sensibility and negative predictive value compared to TRAb (95.6% vs 88.5% and 83.6% vs 54.8%, respectively) but lower specificity and positive predictive value (90.3% vs 100% and 97.5% vs 100%, respectively). The results of TSI assay showed good agreement with those of the TRAb assay (k=0.74). A total of 31 samples were discordant, favoring to TSI assay in all but one case of GD according to clinical diagnosis (TRAb positive and TSI negative). CONCLUSION TSI assay showed an excellent performance for GD diagnosis with a better sensibility than TRAb assay.

Determination of TSH receptor antibodies and its diagnostic worth 1

2008 ◽  
Vol 32 (1) ◽  
pp. -
Author(s):  
Christin Albrecht ◽  
Antje Steveling ◽  
Henri Wallaschofski
Keyword(s):  
Tsh Receptor ◽  
Receptor Antibodies ◽  
Tsh Receptor Antibodies

scholarly journals Effects of l-thyroxine administration, TSH-receptor antibodies and smoking on the risk of recurrence in Graves' hyperthyroidism treated with antithyroid drugs: a double-blind prospective randomized study

2001 ◽  
pp. 475-483 ◽  
Author(s):  
D Glinoer ◽  
P de Nayer ◽  
M Bex
Keyword(s):  
Recurrence Risk ◽  
Initial Diagnosis ◽  
Tsh Receptor ◽  
Antithyroid Drugs ◽  
Free T4 ◽  
Double Blind ◽  
Serum Free ◽  
Risk Of Recurrence ◽  
Receptor Antibodies ◽  
Tsh Receptor Antibodies

OBJECTIVE: In Graves' hyperthyroidism treated with antithyroid drugs (ATD), the overall relapse rate reaches 30-50% following ATD discontinuation. Conflicting results have previously been reported with regard to the usefulness of combining ATD with thyroxine (l-T4), and thereafter maintaining l-T4 treatment after ATD withdrawal. Also, clinicians are in search of useful parameters to predict the risk of a recurrence of hyperthyroidism after ATD treatment. DESIGN: Eighty-two consecutive patients (70 women and 12 men; mean age 36 years) with a first episode of Graves' hyperthyroidism were investigated prospectively; they were treated with ATD for a total of 15 months, combined with l-T4 (for at least 12 months) after they had reached euthyroidism, with the aim of maintaining serum TSH below 2.5 mU/l during the combined therapy. Following ATD discontinuation, the patients were randomly assigned (double-blind placebo-controlled trial) to taking 100 microg/day l-T4 (vs placebo) for an additional year. METHODS: The following determinations were carried out at initial diagnosis: serum total T4 and tri-iodothyronine (T3), free T4 and T3, TSH, TSH-receptor antibodies (TSHR-Ab), thyroid scintigraphy and echography. During ATD treatment, serum free T4 and T3 and TSH concentrations were recorded after 1 (optional), 2, 4, 6, 9, 12 and 15 months, and echography at the end of ATD treatment. During the randomized trial, serum free T4 and T3 and TSH concentrations were checked every 3 months (or until a recurrence). TSHR-Ab titers were measured at initial diagnosis, after 6 months with ATD, and at the end of ATD treatment. RESULTS: l-T4 administration, both during and after ATD treatment, did not improve the final outcome and recurrence rates were similar in placebo and l-T4-treated patients (30%). Two parameters were identified that might be useful to help predict recurrence risks after ATD: (i) positive TSHR-Ab (at the end of ATD treatment) was significantly associated with a greatly increased recurrence risk; and (ii) despite the relatively small number of patients who were smokers, regular cigarette smoking was shown, for the first time, to be significantly associated with an increased recurrence risk. Also, the deleterious effect of smoking was shown to manifest its impact independently of TSHR-Ab titers at the end of ATD treatment. Thus, compared with the overall 30% recurrence risk, non-smoking patients with a negative TSHR-Ab (at the end of ATD) had a lower (18%) recurrence risk; smoking patients with negative TSHR-Ab (at the end of ATD) had a 57% recurrence risk; non-smoking patients with positive TSHR-Ab (at the end of ATD) had a high (86%) recurrence risk; the recurrence risk was 100% in those few patients who both smoked and maintained a positive TSHR-Ab at the end of ATD treatment. CONCLUSIONS: The present study confirmed that l-T4 administration during and after ATD withdrawal did not improve remission rate. Two factors, namely positive TSHR-Ab at the end of ATD treatment and regular smoking habits may represent clinically useful (albeit not absolute) predictors of the risk of recurrence in patients with Graves' hyperthyroidism treated with ATD. However, due to the relatively small number of smoking patients in the present cohort, this conclusion needs to be confirmed by a larger study.

TSH Receptor Antibodies

Thyroid ◽  
2007 ◽  
Vol 17 (10) ◽  
pp. 923-938 ◽  
Author(s):  
Bernard Rees Smith ◽  
Jane Sanders ◽  
Jadwiga Furmaniak
Keyword(s):  
Tsh Receptor ◽  
Receptor Antibodies ◽  
Tsh Receptor Antibodies

Inhibition of thyrotropin-stimulated adenylate cyclase activation and growth of rat thyroid cells, FRTL-5, by immunoglobulin G from patients with primary myxedema: comparison with activities of thyrotropin-binding inhibitor immunoglobulins

1989 ◽  
Vol 120 (1) ◽  
pp. 99-106 ◽  
Author(s):  
B. Y. Cho ◽  
Y. K. Shong ◽  
H. K. Lee ◽  
C.-S. Koh ◽  
H. K. Min
Keyword(s):  
Hashimoto’S Thyroiditis ◽  
Thymidine Incorporation ◽  
Tsh Receptor ◽  
Hashimoto's Thyroiditis ◽  
Thyroid Cells ◽  
Rat Thyroid ◽  
Receptor Antibodies ◽  
Tsh Receptor Antibodies ◽  
Growth Inhibiting ◽  
Blocking Type

Abstract. We studied the blocking type TSH receptor antibodies in 28 patients with primary myxedema and 21 patients with goitrous Hashimoto's thyroiditis by measuring the ability of their IgGs to inhibit TSH binding to its receptor, and to inhibit TSH-stimulated cAMP increase and [3H] thymidine incorporation in a rat thyroid cell line, FRTL-5. The incidences of TSH binding inhibitor immunoglobulin, thyroid stimulation inhibiting immunoglobulin and thyroid growth inhibiting immunoglobulin in patients with primary myxedema were 54.6, 75 and 65.2%, respectively, against 14.3,0 and 17.7%, respectively, in goitrous Hashimoto's thyroiditis. The antibodies inhibited dose-dependently not only TSH stimulated but also Graves' IgG-stimulated cAMP increase and [3H] thymidine incorporation. The TSH binding inhibitor immunoglobulin activities in patients with primary myxedema were significantly correlated with both the thyroid stimulation inhibiting immunoglobulin (r = 0.665; P<0.01) and the thyroid growth inhibiting immunoglobulin (r = 0.618; P<0.01) activity. Thirteen patients whose TSH binding inhibitor immunoglobulin activities were more than 50% had both strong thyroid stimulation inhibiting immunoglobulin (75.1–100%) and thyroid growth inhibiting immunoglobulin (57.4–100%) activities. These data suggest that the vast majority of patients with primary myxedema have potent blocking type TSH receptor antibodies. These might play a role in primary myxedema causing hypothyroidism and thyroid atrophy through inhibiting TSH-stimulated cAMP generation.

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