Study on cutoff value setting for differential diagnosis between Graves' disease and painless thyroiditis using the TRAb (Elecsys TRAb) measurement via the fully automated electrochemiluminescence immunoassay system

Similar Clinical Performance of a Novel Chimeric Thyroid-Stimulating Hormone Receptor Bioassay and an Automated Thyroid-Stimulating Hormone Receptor Binding Assay in Graves' Disease

“…Thyroid weights at the time of diagnosis of hypothyroidism were normal (n = 2), mildly enlarged (n = 5), and enlarged (n = 1). The diagnosis of GD was made on the basis of clinical and laboratory evidence of hyperthyroidism, the presence of a diffusely enlarged thyroid gland, and increased diffuse thyroid uptake 20 minutes after Tc-99m injection ( > 2.0%) and/ or increased vascularity index ( > 80%) in power color Doppler sonography with positive M22-TRAb, as previously reported (8). The diagnosis of PT was based on laboratory evidence of thyrotoxicosis and decreased diffuse thyroid uptake of 20 minutes after Tc-99m injection (< 0.5%) and/or decreased vascularity (< 50%) by power Doppler sonography with negative M22-TRAb, as previously reported (8).…”

“…The M22-TRAb levels in the patients' sera were measured by an inhibition assay kit-Elecsys anti-TSH receptor assay (Roche Diagnostics GmbH, Penzberg, Germany) according to its instruction manual (6,8). This assay detects TSHRAb by using inhibition of a monoclonal antibody (M22) binding the extracelluar domain of porcine TSHR.…”

Cutoff value of thyroid uptake of ^99mTc-pertechnetate to discriminate between Graves&rsquo; disease and painless thyroiditis: a single center retrospective study

“…According to clinical guidelines for Graves' disease and painless thyroiditis (http://japanthyroid.jp/doctor/guideline/english.html), three experienced endocrinologists (H.G, K.K, K.T) who independently and retrospectively diagnosed Graves' disease or painPrevious studies have reported the gray zone for FT3/FT4 ratio as 2.5-3.0 [1], TRAb as 1.0-1.5 IU/L using DYNOtest TRAK human [8] and 0.8-3.0 IU/L using Elecsys TRAb [2]. Intrathyroid hypovascularity is a typical ultrasound finding in patients with painless thyroiditis [4]; however, patients with mild untreated Graves' disease demonstrate similar hypovascularity [5].…”

“…Thyrotoxicosis, 99m Tc-pertechnetate, Differential diagnosis, Cutoff value body (TRAb) level [2,3], semiquantification of intrathyroid vascularity [2,4,5], and measurement of mean peak systolic velocity (PSV) in the thyroid arteries [6,7] are convenient and useful to determine the pathogenesis of thyrotoxicosis. However, because of the presence of the limitation for each diagnostic method, it is sometimes difficult to discriminate Graves' disease from painless thyroiditis when these results are in the so-called gray zone [2,5,8,9]. females) with thyrotoxicosis in whom 99m Tc-pertechnetate uptake were measured after considering all the clinical information such as the levels of thyrotropin (TSH), FT3, FT4, TRAb, and ultrasound findings between 2009 and 2013 at the Diabetes and Endocrine Clinics of Juntendo University Hospital.…”

Differentiation between Graves' disease and painless thyroiditis by diffusion-weighted imaging, thyroid iodine uptake, thyroid scintigraphy and serum parameters

“…Therefore, a number of studies have been undertaken to search for simple and practical parameters that might allow differentiation between the two entities. Thyrotropin receptor antibody (TRAb) assessment has been shown to be a useful marker to make a distinction between the two diseases (2)(3)(15)(16). TRAb is also able to differentiate relapse of GD from development of PT in patients who appear to be in remission following ATD treatment for GD (2).…”