Serum Thyroid Autoantibodies

Rodrigo Arrangoiz MS, MD, FACS, FSSO
  • Hyperthyroidism and hypothyroidism:
    • Are often the result of autoimmune diseases:
      • In which immunoglobulin G (IgG) antibodies:
        • Such as thyroid peroxidase (TPO Ab, previously known as antimicrosomal antibodies), thyroglobulin (Tg Ab), and the TSH receptor (TSHR Ab):
          • Are formed against thyroid proteins
    • The presence of TPOab is commonly associated with patients with hypothyroidism:
      • But can be present in normal individuals who do not display any obvious symptoms of clinical thyroid disease
    • TPOabs are present in approximately 10% of normal individuals:
      • While it was detected in almost 100% of samples of patients with autoimmune hypothyroidism
  • More than 90% of patients with autoimmune thyroid disease (Hashimoto’s thyroiditis and Graves’ disease):
    • Will have elevated titers of second-generation assays for TPO Ab and Tg Ab
  • When biochemical hypothyroidism is found:
    • Measuring TPO Ab can be helpful:
      • Because its result can provide additional information regarding the etiology of the thyroid dysfunction
  • Median serum TSH concentrations are increased within the reference range:
    • Among those with serum TPO Ab and Tg Ab positivity:
      • Compared with those without TPO Ab titers, and are a predictor for the development of biochemical thyroid dysfunction in euthyroid individuals
  • In individuals with subclinical hypothyroidism:
    • Both serum TPO Ab positivity and sonographic characteristics suggestive of chronic thyroiditis:
      • Are associated with an increased likelihood of progression to overt hypothyroidism
  • The TSHR Abs are a group of immunoglobulins:
    • That produce Graves’ hyperthyroidism
    • Measured as:
      • TSH receptor binding, TRAB (TSH-receptor antibody) or in a functional bioassay, thyroid stimulating immunoglobulin (TSI)
    • TSH receptor antibodies:
      • Are being increasingly recommended for monitoring activity of disease to assess response to therapy in Graves’ patients
    • Less commonly, TSH receptor binding antibodies:
      • Can block the TSH receptor and produce hypothyroidism
  • In the setting of normal serum thyroid function:
    • Thyroid antibodies should generally not be measured except in special circumstances:
      • Such as a history of hyperthyroidism during pregnancy or recurrent miscarriages:
        • In these situations, both the stimulating and inhibiting TSHR Abs can cross the placenta to affect fetal thyroid function and potentially induce fetal goiter
      • Although serum thyroid antibody positivity during pregnancy:
        • Is associated with a higher risk of postpartum subacute thyroiditis:
          • Antibody screening in pregnant women is not currently recommended
Unknown's avatar

Published by Rodrigo Arrangoiz MS, MD, FACS, FSSO

My name is Rodrigo Arrangoiz I am a breast surgeon/ thyroid surgeon / parathyroid surgeon / head and neck surgeon / surgical oncologist that works at Center for Advanced Surgical Oncology in Miami, Florida. I was trained as a surgeon at Michigan State University from (2005 to 2010) where I was a chief resident in 2010. My surgical oncology and head and neck training was performed at the Fox Chase Cancer Center in Philadelphia from 2010 to 2012. At the same time I underwent a masters in science (Clinical research for health professionals) at the University of Drexel. Through the International Federation of Head and Neck Societies / Memorial Sloan Kettering Cancer Center I performed a two year head and neck surgery and oncology / endocrine fellowship that ended in 2016. Mi nombre es Rodrigo Arrangoiz, soy cirujano oncólogo / cirujano de tumores de cabeza y cuello / cirujano endocrino que trabaja Center for Advanced Surgical Oncology en Miami, Florida. Fui entrenado como cirujano en Michigan State University (2005 a 2010 ) donde fui jefe de residentes en 2010. Mi formación en oncología quirúrgica y e n tumores de cabeza y cuello se realizó en el Fox Chase Cancer Center en Filadelfia de 2010 a 2012. Al mismo tiempo, me sometí a una maestría en ciencias (investigación clínica para profesionales de la salud) en la Universidad de Drexel. A través de la Federación Internacional de Sociedades de Cabeza y Cuello / Memorial Sloan Kettering Cancer Center realicé una sub especialidad en cirugía de cabeza y cuello / cirugia endocrina de dos años que terminó en 2016.

Leave a comment