Thyroid Receptor Antibodies (TSH Receptor Antibodies), TRAb.

Immunology

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Description

Thyroid receptor is an integral membrane glycoprotein which forms a binding site for TSH on the surface of thyroid follicular cells [2]. Thyroid receptor antibodies ( TRAb ) are measured in patients with the various forms of thyroid disease to identify those with Graves disease. The treatment differs from other forms of hyperthyroidism, as a considerable proportion of these patients undergo long term remission after anti-thyroid drug treatment, and can therefore be spared ablative forms of therapy. As TRAb levels decrease in the course of anti-thyroid drug treatment a rise may indicate an early relapse of hyperthyroidism [1]. Pregnant women with Graves disease, or that have previously been treated for Graves disease are at risk of having a child with neonatal hypothyroidism. TRAb determination provides a method of assessing the risk of the onset of hyperthyroidism in the foetus. Raised levels at differing stages of pregnancy have been linked to an increased risk of having a child with neonatal hypothyroidism, depending on the clinical status of the patient. Guidelines from the European Thyroid Association have made recommendations for when to test for TRAb in different clinical presentations [3].

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Indications

Thyroid disorders / Graves' disease / risk of neonatal hypothyroidism.

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Sample Type

2mL Serum ( Gel 5mL Yellow tube ). Requests from outside Sheffield: Transport at ambient temperature via Royal Mail or Courier.

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Reference Range

Normal range 0 - 0.9 IU/L.Equivocal 1.0 - 1.5 IU/L.Positive >1.5 IU/L.

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Turnaround Time

Within 5 days

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Testing Frequency

Weekly

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References

Costagliola S, et al. Second generation assay for TSH-receptor antibodies has superior diagnostic sensitivity for Graves' disease. J Clin Endocrinol Metab. 1999. 84 ( 1 ):90-97. [Ref 1]Furmaniak J and Smith BR. Immunity to the Thyroid-Stimulating Hormone Receptor. Springer Semin Immunopathology. 1993. 14:309-321. [Ref 2]Laurberg P, et al. Guidelines for TSH-receptor antibody measurements in pregnancy: results of an evidence-based symposium organized by the European Thyroid Association. Eur J Endo. 1998. 139:584-586.[Ref 3].Harrison LC and Leedman PJ. The thyroid stimulating hormone receptor in human disease. Clin Biochem. 1990. 23 ( 1 ):43-48.

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