scholarly journals Thyrotropin-Receptor Antibodies, Immunoglobulin E and Antinuclear Antibodies in Patients with Graves’ Disease and Graves’ Orbitopathy

2021 ◽  
Vol 17 (2) ◽  
pp. 194-199
Author(s):  
M Stoynova
Keyword(s):  
Antinuclear Antibodies ◽  
Immunoglobulin E ◽  
Graves Disease ◽  
Thyrotropin Receptor ◽  
Thyrotropin Receptor Antibodies ◽  
Graves Orbitopathy ◽  
Receptor Antibodies

scholarly journals High Titers of Thyrotropin Receptor Antibodies Are Associated With Orbitopathy in Patients With Graves Disease

2019 ◽  
Vol 104 (7) ◽  
pp. 2561-2568 ◽  
Author(s):  
George J Kahaly ◽  
Christian Wüster ◽  
Paul D Olivo ◽  
Tanja Diana
Keyword(s):  
De Novo ◽  
Graves Disease ◽  
Serum Dilution ◽  
Tertiary Referral Center ◽  
Thyrotropin Receptor Antibodies ◽  
High Dilutions ◽  
Graves Orbitopathy ◽  
Serial Serum ◽  
Receptor Antibodies

Abstract Context Serum TSH receptor autoantibody (TSH-R-Ab) is a biomarker of Graves disease (GD). Studies have shown that the levels of this TSH-R-Ab have clinical significance. Objective To differentiate between thyroidal GD only and Graves orbitopathy (GD + GO). Design Controlled, follow-up study. Setting Academic tertiary referral center for GD + GO. Subjects Sixty patients with GD, GD + GO, and controls. Intervention Serial serum dilution analyses with six automated, ELISA, and cell-based assays for TSH-R-Ab. Main Outcome Measure Differentiation among GD phenotypes. Results All undiluted samples of hyperthyroid-untreated GD patients were positive with the six assays but became negative at dilution 1:9 in four of six assays. In contrast, all undiluted samples of hyperthyroid-untreated GD + GO patients remained positive up to dilution 1:81, P < 0.001. At high dilutions 1:243, 1:729, 1:2187, and 1:6561, the rate of stimulating TSH-R-Ab positivity in the bioassay for GD + GO patients was 75%, 35%, 5%, and 0%, respectively (all P < 0.001). The five ELISA and/or automated assays confirmed this marked difference of anti-TSH-R-Ab detection between GD-only and GD + GO. In comparison, the baseline-undiluted samples of GD vs GD + GO showed an overlap in the ranges of TSH-R-Ab levels. Subsequent to 12-month methimazole treatment, samples from euthyroid GD + GO patients were still TSH-R-Ab positive at the high dilution of 1:243. In contrast, all GD samples were negative already at dilution 1:3. A GD patient with TSH-R-Ab positivity at dilution 1:729 developed de novo GO. Conclusions TSH-R-Ab titers, as determined by dilution analysis, significantly differentiate between GD and GD + GO.

scholarly journals Prospective Trial of Functional Thyrotropin Receptor Antibodies in Graves Disease

2019 ◽  
Vol 105 (4) ◽  
pp. e1006-e1014 ◽  
Author(s):  
George J Kahaly ◽  
Tanja Diana ◽  
Michael Kanitz ◽  
Lara Frommer ◽  
Paul D Olivo
Keyword(s):  
Predictive Value ◽  
Prospective Trial ◽  
Thyroid Stimulating Hormone ◽  
Luciferase Expression ◽  
Graves Disease ◽  
Thyrotropin Receptor ◽  
Tertiary Referral Center ◽  
Thyrotropin Receptor Antibodies ◽  
Receptor Antibodies

Abstract Context Scarce data exist regarding the relevance of stimulatory (TSAb) and blocking (TBAb) thyrotropin receptor antibodies in the management of Graves disease (GD). Objective To evaluate the clinical utility and predictive value of TSAb/TBAb. Design Prospective 2-year trial. Setting Academic tertiary referral center. Patients One hundred consecutive, untreated, hyperthyroid GD patients. Methods TSAb was reported as percentage of specimen-to-reference ratio (SRR) (cutoff SRR < 140%). Blocking activity was defined as percent inhibition of luciferase expression relative to induction with bovine thyrotropin (TSH, thyroid stimulating hormone) alone (cutoff > 40% inhibition). Main Outcome Measures Response versus nonresponse to a 24-week methimazole (MMI) treatment defined as biochemical euthyroidism versus persistent hyperthyroidism at week 24 and/or relapse at weeks 36, 48, and 96. Results Forty-four patients responded to MMI, of whom 43% had Graves orbitopathy (GO), while 56 were nonresponders (66% with GO; P < 0.01). At baseline, undiluted serum TSAb but not thyroid binding inhibitory immunoglobulins (TBII) differentiated between thyroidal GD-only versus GD + GO (P < 0.001). Furthermore, at baseline, responders demonstrated marked differences in diluted TSAb titers compared with nonresponders (P < 0.001). During treatment, serum TSAb levels decreased markedly in responders (P < 0.001) but increased in nonresponders (P < 0.01). In contrast, TBII strongly decreased in nonresponders (P = 0.002). All nonresponders and/or those who relapsed during 72-week follow-up period were TSAb-positive at week 24. A shift from TSAb to TBAb was noted in 8 patients during treatment and/or follow-up and led to remission. Conclusions Serum TSAb levels mirror severity of GD. Their increase during MMI treatment is a marker for ongoing disease activity. TSAb dilution analysis had additional predictive value.

scholarly journals Second Generation Assay for Thyrotropin Receptor Antibodies Has Superior Diagnostic Sensitivity for Graves’ Disease

1999 ◽  
Vol 84 (1) ◽  
pp. 90-97 ◽  
Author(s):  
Sabine Costagliola ◽  
Nils G. Morgenthaler ◽  
Rudolf Hoermann ◽  
Klaus Badenhoop ◽  
Joachim Struck ◽  
...  
Keyword(s):  
Second Generation ◽  
Diagnostic Sensitivity ◽  
Graves Disease ◽  
Thyrotropin Receptor ◽  
Thyrotropin Receptor Antibodies ◽  
Receptor Antibodies

The Prevalence and Clinical Significance of Blocking Thyrotropin Receptor Antibodies in Untreated Hyperthyroid Graves' Disease

Thyroid ◽  
2000 ◽  
Vol 10 (7) ◽  
pp. 579-586 ◽  
Author(s):  
Won Bae Kim ◽  
Hyun Kyung Chung ◽  
Young Joo Park ◽  
Do Joon Park ◽  
Kazuo Tahara ◽  
...  
Keyword(s):  
Clinical Significance ◽  
Graves Disease ◽  
Thyrotropin Receptor ◽  
Thyrotropin Receptor Antibodies ◽  
Receptor Antibodies
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