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ULTIMO FASCICOLOTHE QUARTERLY JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING

Rivista di Medicina Nucleare e Imaging Molecolare

A Journal on Nuclear Medicine and Molecular Imaging
Affiliated to the Society of Radiopharmaceutical Sciences and to the International Research Group of Immunoscintigraphy
Indexed/Abstracted in: Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index (SciSearch), Scopus
Impact Factor 2,413

Periodicità: Trimestrale

ISSN 1824-4785

Online ISSN 1827-1936

 

The Quarterly Journal of Nuclear Medicine 2001 Marzo;45(1):115-9

ORIGINAL ARTICLES 

Evaluation of the 2nd generation radio-receptor assay for anti-TSH receptor antibodies (TRAb) in autoimmune thyroid diseases. Comparison with 1st generation and anti-thyroperoxidase antibodies (AbTPO)

Giovanella L., Cerlani L., Garancini S.

From the Laboratory of Endocrinology and Thyroid Unit Department of Nuclear Medicine University Hospital “Ospedale di Circolo e Fondazione Macchi”, Varese (Italy)

Background. The detec­tion of auto­an­ti­bod­ies to the TSH-recep­tor (TRAb) by radio­-re­cep­tor ­assays (RRA) is wide­ly request­ed in clin­i­cal prac­tice for the diag­nos­tic ­work-up of Graves’ dis­ease and its dif­fe­ren­ti­a­tion ­from dif­fuse thy­roid auton­o­my. Additionally, TRAb meas­ure­ment can be use­ful dur­ing anti­thy­roid ­drug treat­ment of Graves’ dis­ease to eval­u­ate the ­risk of ­relapse ­after the-r­a­py dis­con­tin­u­a­tion. Nevertheless, ­some ­patients affect­ed by Graves’ dis­ease are TRAb-neg­a­tive ­when 1st gen­e-r­a­tion ­assay is ­used.
Methods. In ­this ­study we eval­u­at­ed the diag­nos­tic per­for­mance of a new­ly devel­oped 2nd gen­er­a­tion TRAb ­assay (­TRAK ­human DYNOtest®, ­BRAHMS Diagnostica GmbH, Berlin, Germany) in 74 untreat­ed ­patients affect­ed by Graves’ dis­ease, 53 untreat­ed ­patients affect­ed by Hashimoto’s thyr­oid­itis and 88 ­patients affect­ed by euthyr­oid nod­u­lar goi­ter. We ­also com­pared the new TRAb ­assay ­with the 1st gen­er­a­tion ­test (­TRAK® Assay, ­BRAHMS Diagnostica GmbH, Berlin, Germany) and ­anti-thy­rop­e­rox­i­dase ­assay (AbTPO DYNOtest®, ­BRAHMS Diagnostica GmbH, Berlin).
Results. The 2nd gen­er­a­tion TRAb ­assay ­showed the bet­ter diag­nos­tic sen­si­tiv­ity in Graves’ dis­ease (97%) ­with ­respect to the 1st gen­er­a­tion ­assay (85%) and AbTPO ­assay (64%). The AbTPO ­assay was pos­i­tive in 50 of 53 (94%) ­patients affect­ed by auto­im­mune thyr­oid­itis. The 1st and 2nd gen­er­a­tion TRAb ­assays ­were pos­i­tive in 4 (7%) and 7 (13%) of 53 ­patients affect­ed by auto­im­mune thyr­oid­itis, respec­tive­ly. No ­patients affect­ed by nod­u­lar goi­ter ­showed pos­i­tive 1st and 2nd gen­er­a­tion TRAb ­assay ­while AbTPO lev­els ­were pos­i­tive in 8 of 88 ­patients (spec­i­fic­ity 91%).
Conclusions. In con­clu­sion, the 2nd gen­er­a­tion TRAb ­assay is clear­ly ­more sen­si­tive ­than the 1st gen­er­a­tion ­test and ­should be ­used in clin­i­cal prac­tice to min­i­mize the inci­dence of TRAb-neg­a­tive Graves’ dis­ease. Long ­term pros­pec­tive stud­ies are need­ed to eval­u­ate the prog­nos­tic ­role of 2nd gen­er­a­tion TRAb ­assay in Graves’ dis­ease. The ­assay of AbTPO is the ­best mark­er for auto­im­mune thyr­oid­itis but is clear­ly ­less sen­si­tive ­than 1st and 2nd gen­er­a­tion TRAb ­assays in Graves’ dis­ease. Consequently, AbTPO ­assay ­should not be per­formed in Graves’ dis­ease nei­ther ­alone or in asso­ci­a­tion ­with TRAb.

lingua: Inglese


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