Graves' disease laboratory findings: Difference between revisions
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==Overview== | ==Overview== | ||
The laboratory findings | The laboratory findings in Graves' disease are elevated levels of serum thyroxine (T4) and triiodothyronine (T3), and undetectable levels of serum TSH. | ||
== Laboratory Findings == | == Laboratory Findings == | ||
The laboratory findings | The laboratory findings in Graves' disease are: | ||
*Elevated levels of serum thyroxine (T4) and triiodothyronine (T3) | *Elevated levels of serum thyroxine (T4) and triiodothyronine (T3). | ||
*Undetectable serum TSH. | *Undetectable serum TSH. | ||
*Total T4 and T3 measurements are influenced by multiple conditions affecting serum thyroxine-binding globulin (TBG). Thus, measurement of free thyroid hormone; free T4 (FT4) and free T3 (fT3), is the gold standard for the diagnosis of Graves' disease.<ref name="pmid17673120">{{cite journal |vauthors=Dufour DR |title=Laboratory tests of thyroid function: uses and limitations |journal=Endocrinol. Metab. Clin. North Am. |volume=36 |issue=3 |pages=579–94, v |year=2007 |pmid=17673120 |doi=10.1016/j.ecl.2007.04.003 |url=}}</ref> | |||
Total T4 and T3 measurements are influenced by multiple conditions affecting serum thyroxine-binding globulin (TBG) | * Antibodies against the TSH receptor (TRAbs) are pathognomonic for Graves' disease. They are detectable in the serum of about 98% of untreated patients.<ref name="pmid20594972">{{cite journal |vauthors=Zöphel K, Roggenbuck D, Schott M |title=Clinical review about TRAb assay's history |journal=Autoimmun Rev |volume=9 |issue=10 |pages=695–700 |year=2010 |pmid=20594972 |doi=10.1016/j.autrev.2010.05.021 |url=}}</ref> Detection of TRAbs rules out other causes of thyrotoxicosis.<ref name="pmid23539719">{{cite journal |vauthors=Barbesino G, Tomer Y |title=Clinical review: Clinical utility of TSH receptor antibodies |journal=J. Clin. Endocrinol. Metab. |volume=98 |issue=6 |pages=2247–55 |year=2013 |pmid=23539719 |pmc=3667257 |doi=10.1210/jc.2012-4309 |url=}}</ref> | ||
Antibodies against the TSH receptor (TRAbs) are pathognomonic for Graves' disease. They are detectable in the serum of about 98% of untreated patients.<ref name="pmid20594972">{{cite journal |vauthors=Zöphel K, Roggenbuck D, Schott M |title=Clinical review about TRAb assay's history |journal=Autoimmun Rev |volume=9 |issue=10 |pages=695–700 |year=2010 |pmid=20594972 |doi=10.1016/j.autrev.2010.05.021 |url=}}</ref | * Anti-thyroid peroxidase (TPO) and antithyroglobulin (Tg) antibodies are also detectable in many patients with Graves' disease but it is not recommended to measure these antibodies for diagnosis in all patients. | ||
==References== | ==References== | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1],Associate Editor(s)-in-Chief: Seyedmahdi Pahlavani, M.D. [2]
Overview
The laboratory findings in Graves' disease are elevated levels of serum thyroxine (T4) and triiodothyronine (T3), and undetectable levels of serum TSH.
Laboratory Findings
The laboratory findings in Graves' disease are:
- Elevated levels of serum thyroxine (T4) and triiodothyronine (T3).
- Undetectable serum TSH.
- Total T4 and T3 measurements are influenced by multiple conditions affecting serum thyroxine-binding globulin (TBG). Thus, measurement of free thyroid hormone; free T4 (FT4) and free T3 (fT3), is the gold standard for the diagnosis of Graves' disease.[1]
- Antibodies against the TSH receptor (TRAbs) are pathognomonic for Graves' disease. They are detectable in the serum of about 98% of untreated patients.[2] Detection of TRAbs rules out other causes of thyrotoxicosis.[3]
- Anti-thyroid peroxidase (TPO) and antithyroglobulin (Tg) antibodies are also detectable in many patients with Graves' disease but it is not recommended to measure these antibodies for diagnosis in all patients.
References
- ↑ Dufour DR (2007). "Laboratory tests of thyroid function: uses and limitations". Endocrinol. Metab. Clin. North Am. 36 (3): 579–94, v. doi:10.1016/j.ecl.2007.04.003. PMID 17673120.
- ↑ Zöphel K, Roggenbuck D, Schott M (2010). "Clinical review about TRAb assay's history". Autoimmun Rev. 9 (10): 695–700. doi:10.1016/j.autrev.2010.05.021. PMID 20594972.
- ↑ Barbesino G, Tomer Y (2013). "Clinical review: Clinical utility of TSH receptor antibodies". J. Clin. Endocrinol. Metab. 98 (6): 2247–55. doi:10.1210/jc.2012-4309. PMC 3667257. PMID 23539719.