Consensus about the TRAb
importance, regarding the prediction of GD relapse and remission has not been reached yet.
euthyroid status and negative TRAb
. The only laboratory basis for diagnosing our patient as having Graves' disease was his elevated TSAb level.
Subtyping was based on measurement of TRAb
in serum (TRAb+ patients were classified as Graves' disease), and no other cause for the hyperthyroidism was identified.
A number of authors have found a positive correlation between the levels of TRAb
and the presence or severity of GO (4,6,17-21).
TABLE Autoimmune markers in thyroid disorders % TRAb
% OF >3.4 U/L >10 U/L STUDY PATIENTS LR+ LR- LR+ LR- Graves' disease 68 4.6 0.1 13.0 0.2 CAHT 20 0.2 4.7 0.1 2.8 Subacute 4 0.2 3.0 0.0 2.4 thyroiditis Thyroid nodules 6 0.2 3.4 0.0 2.4 Others 2 0.8 1.4 0.0 2.3 % AMA % THYROGLOBULIN POSITIVE POSITIVE LR+ LR- LR+ LR- Graves' disease 1.3 0.6 1.1 0.9 CAHT 1.4 0.2 1.4 0.6 Subacute 0.1 3.6 0.5 1.5 thyroiditis Thyroid nodules 0.1 4.1 0.1 2.0 Others 0.0 2.8 0 2.0 AMA, antimicrosomal antibodies; CAHT, chronic autoimmune (Hashimoto's) thyroiditis; LR+, positive likelihood ratio; LR-, negative likelihood ratio; TRAb
, thyrotropin receptor antibodies Source: Khoo DHC, et al.
The patient has not received antithyroid therapy for more than four years although TSAb, TRAb
and anti-thyroglobulin antibody levels continue to be abnormal.
Variable Value Normal value TRAb
(IU/L) 16.3 0-1.9 TSAb (%) 767 0-120 Thyroglobulin (ng/mL) 183 0-33.7 TPOAb (U/mL) 9 0-15 TgAb (IU/mL) 40 0-27 TRAb
, anti-thyroid-stimulating receptor antibody; TSAb, anti-thyroid-stimulating antibody; TPOAb, anti-thyroid peroxidase antibody; TgAb, anti-thyroglobulin antibody.
Detection of TRAb
has become the most commonly used method to differentiate the etiology of thyrotoxicosis when RAI uptake is unavailable or contraindicated .
The majority of TRAb
assays detect both TSI and TBAb.
(21) least as effective comparable in the as MMC (comparable two groups success rates in the two groups) Perop: Peroperative, TRAB
: Trabeculectomy, Phaco: Phacoemulsification, Tube: Tube shunt surgery, Re-TRAB: Patients undergoing trabeculectomy after a previous failed glaucoma surgery, TA: Triamcinolone acetonide, SC: Subconjunctival, IB: Intrableb, RB: Retrobulbar, ST: Sub-Tenon, IC: Intracameral, MMC: Mitomycin C