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Practice Guideline
. 2024 Dec 21;24(1):274.
doi: 10.1186/s12902-024-01809-9.

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

Sanjay Kalra  1 , Shahjada Selim  2 , Dina Shrestha  3 , Noel Somasundaram  4 , Syed Abbas Raza  5 , Manash P Baruah  6 , Saptarshi Bhattacharya  7 , Sharvil Gadve  8 , Ganapathi Bantwal  9 , Rakesh Sahay  10
Affiliations
Practice Guideline

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

Sanjay Kalra et al. BMC Endocr Disord. .

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.

Keywords: Best practices; Diagnosis; Graves’ disease; Monitoring; Prognosis; South Asia; TRAbs; TSH receptor antibodies.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: Since this is an expert opinion about the best practices in the laboratory diagnosis, management, prognosis, and monitoring of Graves’ Disease, and no human clinical data was collected, ethics committee approval was not deemed to be necessary by the authors. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Recommended algorithm for laboratory management of Graves’ Disease in non-pregnant adult patients
See this image and copyright information in PMC

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