Best practices in the laboratory diagnosis, prognostication, prediction, and monitoring of Graves’ disease: role of TRAbs

Abstract Graves' disease (GD) is an autoimmune disorder characterized by activation of the TSH receptor by stimulatory autoantibodies (TSH Receptor Antibodies, or TRAbs), leading to unregulated thyroid hormone production. Diagnosis is largely based on the typical clinical picture and laboratory...

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Main Authors: Sanjay Kalra, Shahjada Selim, Dina Shrestha, Noel Somasundaram, Syed Abbas Raza, Manash P. Baruah, Saptarshi Bhattacharya, Sharvil Gadve, Ganapathi Bantwal, Rakesh Sahay
Format: Article
Language:English
Published: BMC 2024-12-01
Series:BMC Endocrine Disorders
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Online Access:https://doi.org/10.1186/s12902-024-01809-9
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author Sanjay Kalra
Shahjada Selim
Dina Shrestha
Noel Somasundaram
Syed Abbas Raza
Manash P. Baruah
Saptarshi Bhattacharya
Sharvil Gadve
Ganapathi Bantwal
Rakesh Sahay
author_facet Sanjay Kalra
Shahjada Selim
Dina Shrestha
Noel Somasundaram
Syed Abbas Raza
Manash P. Baruah
Saptarshi Bhattacharya
Sharvil Gadve
Ganapathi Bantwal
Rakesh Sahay
author_sort Sanjay Kalra
collection DOAJ
description Abstract Graves' disease (GD) is an autoimmune disorder characterized by activation of the TSH receptor by stimulatory autoantibodies (TSH Receptor Antibodies, or TRAbs), leading to unregulated thyroid hormone production. Diagnosis is largely based on the typical clinical picture and laboratory thyroid panel. Establishment of elevated serum levels of TRAbs by competitive binding assay or cell-binding assay has its unique role in diagnosis and management of GD, especially in the differential diagnosis, therapy selection, prognostication, evaluation of thyroid function during pregnancy, peri-conceptional and neonatal thyroid workup, and in certain special situation. Inclusion of TRAbs in GD diagnostic algorithm can improve cost-effectiveness of GD management. The current best practice guidelines were developed to provide evidence-based recommendations in the use of TRABs in GD management for healthcare providers in South Asia. A panel of endocrinologists with minimum 10 years of clinical experience in thyroid disorders reviewed existing literature and their quality, and after deliberation and discussion, developed 21 recommendations surrounding the best practices surrounding the role of TRAbs in GD management.
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institution Kabale University
issn 1472-6823
language English
publishDate 2024-12-01
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series BMC Endocrine Disorders
spelling doaj-art-71a561f0f9b44f89a0653d0cd248821c2024-12-22T12:30:54ZengBMCBMC Endocrine Disorders1472-68232024-12-0124111210.1186/s12902-024-01809-9Best practices in the laboratory diagnosis, prognostication, prediction, and monitoring of Graves’ disease: role of TRAbsSanjay Kalra0Shahjada Selim1Dina Shrestha2Noel Somasundaram3Syed Abbas Raza4Manash P. Baruah5Saptarshi Bhattacharya6Sharvil Gadve7Ganapathi Bantwal8Rakesh Sahay9Bharti HospitalDepartment of Endocrinology, Bangabandhu Sheikh Mujib Medical University (BSMMU)Norvic International Hospital and Medical CollegeThe National Hospital of Sri LankaShaukat Khanum Cancer Hospital & Research CenterDiabetes, Endocrine & Metabolic Disease, Apollo Excelcare HospitalsEndocrinology and Diabetes, Indraprastha Apollo HospitalsExcel Endocrine CentreDepartment of Endocrinology, St. John’s Medical College & HospitalDepartment of Endocrinology, Osmania Medical College & Osmania General HospitalAbstract Graves' disease (GD) is an autoimmune disorder characterized by activation of the TSH receptor by stimulatory autoantibodies (TSH Receptor Antibodies, or TRAbs), leading to unregulated thyroid hormone production. Diagnosis is largely based on the typical clinical picture and laboratory thyroid panel. Establishment of elevated serum levels of TRAbs by competitive binding assay or cell-binding assay has its unique role in diagnosis and management of GD, especially in the differential diagnosis, therapy selection, prognostication, evaluation of thyroid function during pregnancy, peri-conceptional and neonatal thyroid workup, and in certain special situation. Inclusion of TRAbs in GD diagnostic algorithm can improve cost-effectiveness of GD management. The current best practice guidelines were developed to provide evidence-based recommendations in the use of TRABs in GD management for healthcare providers in South Asia. A panel of endocrinologists with minimum 10 years of clinical experience in thyroid disorders reviewed existing literature and their quality, and after deliberation and discussion, developed 21 recommendations surrounding the best practices surrounding the role of TRAbs in GD management.https://doi.org/10.1186/s12902-024-01809-9Graves’ diseaseTSH receptor antibodiesTRAbsSouth AsiaBest practicesDiagnosis
spellingShingle Sanjay Kalra
Shahjada Selim
Dina Shrestha
Noel Somasundaram
Syed Abbas Raza
Manash P. Baruah
Saptarshi Bhattacharya
Sharvil Gadve
Ganapathi Bantwal
Rakesh Sahay
Best practices in the laboratory diagnosis, prognostication, prediction, and monitoring of Graves’ disease: role of TRAbs
BMC Endocrine Disorders
Graves’ disease
TSH receptor antibodies
TRAbs
South Asia
Best practices
Diagnosis
title Best practices in the laboratory diagnosis, prognostication, prediction, and monitoring of Graves’ disease: role of TRAbs
title_full Best practices in the laboratory diagnosis, prognostication, prediction, and monitoring of Graves’ disease: role of TRAbs
title_fullStr Best practices in the laboratory diagnosis, prognostication, prediction, and monitoring of Graves’ disease: role of TRAbs
title_full_unstemmed Best practices in the laboratory diagnosis, prognostication, prediction, and monitoring of Graves’ disease: role of TRAbs
title_short Best practices in the laboratory diagnosis, prognostication, prediction, and monitoring of Graves’ disease: role of TRAbs
title_sort best practices in the laboratory diagnosis prognostication prediction and monitoring of graves disease role of trabs
topic Graves’ disease
TSH receptor antibodies
TRAbs
South Asia
Best practices
Diagnosis
url https://doi.org/10.1186/s12902-024-01809-9
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