Clinical utility of assays for TSH receptor antibodies

TSH receptor antibodies, which may be stimulatory or blocking, play an important role in the pathogenesis of Graves' disease and Hashimoto's thyroiditis, respectively. In recent years, the ability to accurately and reproducibly measure TSH receptor antibodies in clinical circumstances has improved, and their measurement may alter the diagnostic and therapeutic approach to such patients. The purpose of the present review is to discuss the measurement techniques, utility, pitfalls, and limitations of TSI-I receptor antibody assays. The measurement of TSH receptor antibody levels can be used to help predict the recurrence of Graves' disease, to help diagnose Graves' ophthalmopathy, and to determine the likelihood that neonatal Graves' disease will occur. TSH receptor blocking antibodies are useful in determining the clinical manifestations of hypothyroidism.