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TSH Receptor Antibodies

70 Azn
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Anti-TSHR antibodies (TRAb) are a heterogeneous group of autoantibodies that interact with thyroid-stimulating hormone (TSH) receptors in the thyroid gland.

  • Stimulating Anti-TSHR antibodies increase thyroid function, leading to diffuse goiter and hyperthyroidism.
  • Blocking Anti-TSHR antibodies inhibit TSH activity, causing thyroid atrophy and hypothyroidism.
  • Anti-TSHR primarily belong to the IgG immunoglobulin class and can cross the placental barrier, potentially affecting newborns.
  • Both types of antibodies may be present simultaneously in the same patient.
  • These antibodies are the direct cause of Graves' disease and autoimmune thyroiditis, as well as transient thyroid dysfunction in newborns.

The Anti-TSHR test detects both stimulating and blocking antibodies in the blood and is a key diagnostic tool for differentiating hyperthyroidism and hypothyroidism syndromes.

 

Clinical Significance

  • Anti-TSHR is a major clinical and laboratory marker of Graves' disease.
  • This test is crucial for differentiating Graves' disease from other causes of hyperthyroidism (e.g., toxic nodular goiter, granulomatous thyroiditis, or exogenous thyroxine intake).
  • Stimulating TRAb (TSAb) are detected in 85–100% of Graves' disease cases and serve as a diagnostic criterion.
  • Anti-TSHR levels correlate with disease activity and the severity of ophthalmopathy.

    Clinical Significance

  • Anti-TSHR is a major clinical and laboratory marker of Graves' disease.
  • This test is crucial for differentiating Graves' disease from other causes of hyperthyroidism (e.g., toxic nodular goiter, granulomatous thyroiditis, or exogenous thyroxine intake).
  • Stimulating TRAb (TSAb) are detected in 85–100% of Graves' disease cases and serve as a diagnostic criterion.
  • Anti-TSHR levels correlate with disease activity and the severity of ophthalmopathy.
     

No smoking for at least 1 hour before the test.

  1. Differential diagnosis of hyperthyroidism and hypothyroidism syndromes.
  2. Monitoring treatment response and predicting relapse risk in Graves' disease.
  3. Predicting transient thyroid dysfunction in newborns.
  4. Evaluating symptoms of hyperthyroidism, such as:
    • Irritability, anxiety
    • Tremors
    • Palpitations
    • Oligoamenorrhea
    • Unexplained weight loss despite increased appetite
    • Heat intolerance
    • Exophthalmos (eye bulging) and pretibial myxedema
  5. Assessing atypical Graves' disease cases:
    • Mild or unclear hyperthyroidism symptoms
    • Poorly palpable goiter
    • Ophthalmopathy with normal thyroid function (euthyroid state)
    • Unilateral ophthalmopathy
  6. Evaluating hypothyroidism symptoms, including:
    • Fatigue, drowsiness
    • Poor concentration and memory
    • Unexplained weight gain despite appetite loss
    • Cold intolerance
  7. Screening pregnant women who:
    • Have a history of Graves' disease treated with surgery or radioactive iodine therapy
    • Are on antithyroid medications
    • Have signs of hypothyroidism

Causes of a Positive Anti-TSHR Test

  • Graves' disease (Basedow's disease)
  • Autoimmune thyroiditis (e.g., Hashimoto’s thyroiditis)

Causes of a Negative Anti-TSHR Test

  • Absence of autoimmune thyroid disease
  • Successful disease management during treatment
     

    Factors Affecting Test Results

  • Anti-TSHR levels decrease with antithyroid drug therapy (e.g., methimazole, propylthiouracil).