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CHEN Li-li, YU Yi-fei, ZENG Fang-fang, et al. Clinical value of 3rd generation assay of thyroid stimulating hormone receptor antibody (Elecsys) for differential diagnosis of thyrotoxicosis[J]. Chin J Clin Med, 2021, 28(1): 80-84. DOI: 10.12025/j.issn.1008-6358.2021.20201871
Citation: CHEN Li-li, YU Yi-fei, ZENG Fang-fang, et al. Clinical value of 3rd generation assay of thyroid stimulating hormone receptor antibody (Elecsys) for differential diagnosis of thyrotoxicosis[J]. Chin J Clin Med, 2021, 28(1): 80-84. DOI: 10.12025/j.issn.1008-6358.2021.20201871

Clinical value of 3rd generation assay of thyroid stimulating hormone receptor antibody (Elecsys) for differential diagnosis of thyrotoxicosis

Funds: 

Research Project of Shanghai Health and Family Planning Committee 20154Y0013

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  • Received Date: August 23, 2020
  • Accepted Date: September 27, 2020
  • Objective 

    To explore the applicability of 3rd generation thyroid stimulating hormone receptor antibody (TRAb) assay (Elecsys) in clinical differentiation of thyrotoxicosis.

    Methods 

    154 subjects with untreated thyrotoxicosis, who were admitted to Huashan Hospital between January 2016 and May 2018 were retrospectively selected. Thyroid function, TRAb, radioactive iodine uptake (RAIU), and mean peak systolic velocity of superior thyroid artery (STA-PSV) were detected. Receiver operating characteristic (ROC) curves were plotted to compare the value of the third generation TRAb and STA-PSV in the differential diagnosis of Graves'disease (GD) and destructive thyroiditis (DT).

    Results 

    Of the 154 subjects with untreated thyrotoxicosis enrolled, 111 (72.0%) were female, their mean age were 38.42 years. Totally, 117 (76.0%) were diagnosed as GD. The area under the ROC curve for TRAb in the differential diagnosis of thyrotoxicosis was 0.984 (95%CI 0.967-1.000), superior to that of STA-PSV (AUC 0.903, 95%CI 0.839-0.967). The best cutoff point of TRAb was 1.7 U/L, the sensitivity and specificity in distinguishing GD from DT were 94.8% and 94.3%, respectively. If TRAb cutoff point was set 3.6 U/L, its specificity and postive predictive value in GD differentiation reached 100%. There are 5 TRAb negative (< 1.7 U/L) GD cases, all of whom have significantly elevated STA-PSV.

    Conclusions 

    The 3rd generation TRAb assay (Elecsys) is sensitive and specific in the differential diagnosis of thyrotoxicosis.

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