Thyroid diseases

Clinical information

The sensitive equilibrium of the thyroid hormone loop can be disturbed due to the presence of different autoantibodies. Autoimmune thyroid diseases are characterised by antibodies against thyroid microsomes, whose main target antigen is thyroperoxidase (TPO), and antibodies against thyroglobulin (TG) or the receptor of thyrotropin (also known as thyroid stimulating hormone (TSH). The most frequent autoimmune thyroid diseases are Hashimoto’s autoimmune thyroiditis (AIT) and immunohyperthyroidism, also known as Graves’ disease. While AIT can manifest as a thyroid overfunction (hyperthyroidism) or underfunction (hypothyroidism), Graves’ disease is always associated with hyperthyroidism.
Hashimoto’s thyroiditis leads to autoimmune-mediated lymphocytic infiltration and consequently to a destruction of the thyroid tissue, in the long term often resulting in reduced thyroid hormone production.
A special form of autoimmune thyroiditis is post-partum thyroiditis, a temporary hypothyroid functional disorder of the thyroid accompanied by high titers of anti-TPO antibodies. The disease affects around 5 to 9% of women after giving birth, and the risk is especially high in diabetes mellitus patients.
The permanent stimulation of TSH receptors by binding of autoantibodies is one of the most relevant factors for the pathogenesis of Graves’ disease. The permanent binding activates signal cascades leading to an increased uptake of iodine by the thyroid. As a consequence, the thyroid hormones triiodothyronine (T3) and thyroxine (T4) are produced and secreted in larger quantities.

Diagnostics

In suspected cases of thyroid disease, the TSH concentration in serum should be determined. An increased TSH level indicates hypothyroidism, low values indicate hyperthyroidism. Additionally, the values of the free thyroid hormones FT3 or FT4 in serum should be determined. The detection of antibodies against thyroid antigens enables differentiation of autoimmune thyroid diseases from acute (bacterial) or subacute (non-infectious) thyroiditis or non-autoimmune disturbed thyroid hormone regulation.
With Hashimoto’s thyroiditis, anti-TPO antibodies are detected in 90% of patients; autoantibodies against TSH receptor (TRAb) are found in 6 to 60%, and anti-TG antibodies occur in 45 to 60% of cases.
TRAb are the most important serological marker in Graves’ disease. They are detectable in over 90% of patients. Higher antibody titers are associated with severe disease courses. Moreover, anti-TPO and anti-TG antibodies occur with a prevalence of approx. 80% and 30%, respectively.
For sufficient differential diagnostics, the overall picture obtained from the investigation of different parameters must be evaluated. Besides serological analyses, clinical examinations (e.g. ultrasound, scintigraphy) and symptoms must be taken into account.

Selected Products

Method
Parameter
Substrate
Species
IIFT
thyroid gland
(MAb + TAb)
thyroid gland
monkey
IIFT
thyroid gland (MAb + TAb)
mitochondria (AMA)
thyroid gland
kidney
(2 BIOCHIPs per field)
monkey
rat
IIFT
Polyendocrinopathy Mosaic
thyroid gland (MAb + TAb)
pancreas islets
adrenal cortex
ovarian antigens
Leydig cells
parietal cells (PCA)
6 BIOCHIPs per field:
thyroid gland
pancreas
adrenal gland
ovary
testis
stomach

monkey
monkey
monkey
monkey
monkey
monkey
IIFT
EUROPLUS
thyroid gland (MAb + TAb)
thyroglobulin (TG)
2 BIOCHIPs per field:
thyroid gland
TG BIOCHIPs

monkey
human
IIFT
antibodies against thyroid microsomes
(MAb control)
ELISA
thyroid peroxidase
(TPO)
antigen-coated
microplate wells
RIA
thyroid peroxidase (TPO)
coated tubes (CT)
antigen-coated
tubes
native thyroid
peroxidase, human
RIA
thyroid peroxidase (TPO)
precipitation
labelled antigen
native thyroid
peroxidase, human
RIA
thyroid peroxidase (TPO)
magnetic separation
labelled antigen
native thyroid
peroxidase, human
IIFT
antibodies against thyroglobulin
(TAb control)
ELISA
thyroglobulin
(TG)
antigen-coated
microplate wells
RIA
thyroglobulin (TG)
coated tubes (CT); IRMA
antibody-coated
tubes
native
thyroglobulin
RIA
thyroglobulin (TG)
coated tubes (CT)
antigen-coated
tubes
native thyroglobulin,
human
RIA
thyroglobulin (TG)
magnetic separation
labelled antigen
native thyroglobulin,
human
ELISA
TSH receptor
(thyrotropin receptor)
antigen-coated
microplate wells
ELISA
TSH receptor
(thyrotropin receptor)
Fast ELISA
antigen-coated
microplate wells
RIA
TSH receptor
coated tubes (CT)
antigen-coated
tubes
native TSH receptor,
porcine
RIA
free triiodothyronine (FT3)
coated tubes (CT)
antibody-coated
tubes
triiodothyronine,
human
ELISA
reverse triiodothyronine (RT3)
antibody-coated
microplate wells
RIA
free thyroxine (FT4)
coated tubes (CT)
antibody-coated
tubes
thyroxine,
human
RIA
Turbo thyrotropin (TSH)
coated tubes (CT); IRMA
antibody-coated
tubes
thyrotropin,
human
RIA
calcitonin
coated tubes (CT); IRMA
antibody-coated
tubes
calcitonin,
human
ELISA
calcitonin
antibody-coated
microplate wells
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