{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T05:24:33Z","timestamp":1783488273899,"version":"3.55.0"},"reference-count":33,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2017,4,10]],"date-time":"2017-04-10T00:00:00Z","timestamp":1491782400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Endocrinology"],"published-print":{"date-parts":[[2017,5]]},"abstract":"Summary<\/jats:title>TSH<\/jats:styled-content> receptor antibody (TRA<\/jats:styled-content>b) plays a key role in the pathogenesis of Graves\u2019 disease (GD<\/jats:styled-content>), and its levels correlate with the clinical course. The second\u2010 and third\u2010generation TRA<\/jats:styled-content>b assays have >95% sensitivity and specificity for the diagnosis of GD<\/jats:styled-content> and have improved the utility of TRA<\/jats:styled-content>b to predict relapse. TRA<\/jats:styled-content>b levels decline with antithyroid drug (ATD<\/jats:styled-content>) therapy and after thyroidectomy. Its level increases for a year following radioactive iodine (RAI<\/jats:styled-content>) therapy, with a gradual fall thereafter. TRA<\/jats:styled-content>b level >12\u00a0IU\/l at diagnosis of GD<\/jats:styled-content> is associated with 60% risk of relapse at 2\u00a0years and 84% at 4\u00a0years. The prediction of risk of relapse improves further to >90% with TRA<\/jats:styled-content>b >7\u00b75\u00a0IU\/l at 12\u00a0months or >3\u00b785\u00a0IU\/l at cessation of ATD<\/jats:styled-content> therapy. TRA<\/jats:styled-content>b tests are not expensive, and hence, TRA<\/jats:styled-content>b measurements at presentation, after 12\u00a0months and\/or 18\u00a0months (at cessation) of ATD<\/jats:styled-content> therapy, could potentially guide treatment choices in GD<\/jats:styled-content>. Elevated TRA<\/jats:styled-content>b favours definitive treatment in the form of RAI<\/jats:styled-content> or thyroidectomy, depending on the presence or absence of moderate\u2010to\u2010severe Graves\u2019 ophthalmopathy (GO<\/jats:styled-content>) and the ability to comply with radiation protection requirements. Use of ATD<\/jats:styled-content>s in early pregnancy is associated with increased risk of congenital anomalies; early ablative treatment (RAI<\/jats:styled-content>\/surgery) should be considered in women of childbearing age at higher risk of relapse of GD<\/jats:styled-content>. TRA<\/jats:styled-content>b \u22655\u00a0IU\/l in pregnant women with current or previously treated GD<\/jats:styled-content> is associated with increased risk of foetal and neonatal thyrotoxicosis, and hence needs close monitoring. TRA<\/jats:styled-content>b levels parallel the course of GO<\/jats:styled-content>, and elevated TRA<\/jats:styled-content>b is an indication for steroid prophylaxis to prevent progression of GO<\/jats:styled-content> with RAI<\/jats:styled-content> therapy.<\/jats:p>","DOI":"10.1111\/cen.13327","type":"journal-article","created":{"date-parts":[[2017,3,14]],"date-time":"2017-03-14T15:59:10Z","timestamp":1489507150000},"page":"652-657","source":"Crossref","is-referenced-by-count":55,"title":["Measuring TSH<\/scp> receptor antibody to influence treatment choices in Graves\u2019 disease"],"prefix":"10.1111","volume":"86","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9082-2387","authenticated-orcid":false,"given":"Asha","family":"Hesarghatta Shyamasunder","sequence":"first","affiliation":[{"name":"Department of Diabetes and Endocrinology Aberdeen Royal Infirmary Aberdeen 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