Download Thyroid Stimulating Hormone Receptor Antibody Testing

LAB TEST CONNECT
Thyroid Stimulating Hormone
Receptor Antibody Testing
(TRAb) for Graves Disease
David Corwin, M.D. and Joel Adams, MLS (ASCP) CM
CLINICAL APPLICATION
Thyroid Stimulating Hormone Receptor Antibody (TRAb) is useful for the
differential diagnosis of clinically suspected Graves’ disease. TRAb can be
used in the differential diagnosis of thyrotoxicosis in patients with nondiagnostic clinical findings or thyroid radioisotope scans.
Additional applications for TRAb are in determining the risk of neonatal
thyrotoxicosis in a fetus of a pregnant female with active or past active
Graves’ disease, differential diagnosis of gestational thyrotoxicosis and
assessing the risk of Graves’ disease relapse after antithyroid drug treatment.
The TRAb test can also be used in the differential diagnosis of toxic nodular
goiter, thyroid cancer, thyrotoxicosis factitia, viral subacute thyroiditis,
pituitary tumor, and head and neck cancer.
CLINICAL BACKGROUND
Graves disease is an autoimmune disorder, caused by the production of
thyroid autoantibodies that activate the TSH-receptor. The antibodies
stimulate thyroid hormone production that is not inhibited by the usual
feedback mechanism, leading to hyperthyroidism and thyrotoxicosis.
Graves disease is the most common cause of hyperthyroidism and comprises
60-90% of all cases. The condition usually presents itself during midlife, but
also appears in children, adolescents, and the elderly. It affects up to 2% of
the female population, and is more common in females than in males.
CLINICAL MANAGEMENT
Treatments for Graves disease do not affect the underlying autoimmune
disease process, but are designed to ablate thyroid tissue or block thyroid
hormone synthesis. Symptom relief is usually not immediate, but can be
achieved over time as the treatments take effect and thyroid levels return to
normal.
www.paml.com
ORDER CODE:
ATSHR
Quick Facts
nThe prevalence of
hyperthyroidism is
approximately 2-3% of the
general population.
nThe majority of cases
of hyperthyroidism are
a consequence of Graves’
disease.
nThe hyperthyroidism of
Graves disease is caused
by autoantibodies which
stimulate TSH receptors.
nDetection of TSH receptor
antibodies (TRAb) can aid
in the differential diagnosis
of Graves’ disease when
combined with clinical
findings.
nThe TRAb assay shows
85% sensitivity and 100%
specificity for identifying
patients with Graves’
disease.
nThe TRAb assay has a
shorter turn-around time,
less analytical variability
and is less expensive than
the cell culture bioassay
for thyroid-stimulating
immunoglobulins.
Thyroid Stimulating Hormone Receptor Antibody Testing-PAML-TSHR_0001
©2016 PAML, LLC — V2 REV121916
Thyroid Stimulating Hormone Receptor
Antibody Testing (TRAb) for Graves Disease
TEST INFORMATION
THYROID STIMULATING HORMONE RECEPTOR ANTIBODY TRAB
TEST CODE
ATSHR
BILLING CODE
ATSHR
SYNONYMS
CONTAINER TYPE
SUPPLY ITEM
NUMBER
STORE AND
TRANSPORT
SPECIMEN TYPE
PREFERRED VOLUME
MINIMUM VOLUME
TRAb, TBII, Anti-Thyrotropin, Anti-TSHR, Thyrotropin Receptor Antibody, TSH Receptor Antibody, TSH
Receptor Blocking Antibody, Thyroid Stimulating Hormone Receptor Antibody
Serum separator tube (gold, brick, SST, or corvac)
1467
Store and transport frozen. Separate samples must be submitted when multiple tests are ordered
Serum, Frozen
1.0 mL
0.30 mL
COLLECTION
PROCEDURE
Collect 4 mL blood in a serum separator tube
SPECIMEN
PROCESSING
Separate serum from cells and transfer to a standard PAML aliquot tube and freeze
ROOM TEMP
1 day
REFRIGERATED
FROZEN -20C
UNACCEPTABLE
CONDITION
DEPARTMENT
CPT CODES
TEST SCHEDULE
TURNAROUND TIME
METHOD
TEST INCLUDES
REFERENCE
RANGES
CLINICAL
SIGNIFICANCE
3 days
1 month
Plasma samples; grossly hemolyzed or lipemic serum specimens ; samples from patients on heparin
therapy; heat-inactivated samples; samples stabilized with azide
PAML Special Immunology
83520
Tue., Thu., Sat.
2-4 days
Quantitative Electrochemiluminescent Immunoassay
TSH Receptor Antibody
TSH Receptor Antibody IU/L
LT 1.76
Positive results are consistent with autoimmune thyroid disease.
SELECTED REFERENCES
1.
2.
3.
4.
Package Insert: KRONUS TSH Receptor Antibody (TRAb) ELISA Kit, Manufactured by KRONUS, 170 S. Seneca Springs Way, Suite 105, Star, ID 83669 USA P/N 196c v.02/11
Lab Tests Online. Graves Disease. http://labtestsonline.org/understanding/conditions/graves/
American Thyroid Association. Graves Disease. http://www.thyroid.org/what-is-graves-disease/
National Endocrine and Metabolic Diseases Information Service. Graves Disease. http://www.endocrine.niddk.nih.gov/pubs/graves/
For more information, please contact your local sales representative.