{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T23:51:41Z","timestamp":1781653901102,"version":"3.54.5"},"reference-count":32,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T00:00:00Z","timestamp":1777334400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T00:00:00Z","timestamp":1777334400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100005760","name":"University of Gothenburg","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100005760","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Thyroid Res"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Graves\u2019 hyperthyroidism is caused by stimulatory autoantibodies. Its diagnosis and monitoring are commonly based on measurement of thyrotropin receptor antibodies (TRAb) with unspecific immunoassays, that also detect neutral and blocking antibodies. TRAb analyzed using the Siemens IMMULITE\n                      <jats:sup>\u00ae<\/jats:sup>\n                      2000 TSI immunoassay (TRAb-IM), designed to target stimulatory immunoglobulins, represents a promising alternative. This study aimed to determine the clinical performance of TRAb-IM and the Thermo Fisher BRAHMS TRAK KRYPTOR immunoassay (TRAb-KR) in a real-world setting.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Over 3 months, TRAb-IM was analyzed in samples collected to measure TRAb-KR after referral for thyrotoxicosis or at the time of discontinuation of antithyroid drugs (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009168). Data on thyroid hormones, TRAb-KR, and date of start\/discontinuation of antithyroid drugs was collected.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Agreement analysis for Graves\u2019 disease diagnosis between the assays yielded a Gwet\u2019s AC1 of 0.69 (95% confidence interval [CI] 0.51\u20130.86) for the samples collected after referral for thyrotoxicosis (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009122). In this group, sensitivity (95% CI) for TRAb-IM and TRAb-KR was 97% (86\u2013100) and 78% (62\u201390), respectively, in overt hyperthyroidism (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200949), and 71% (42\u201392) and 43% (18\u201371), respectively, in subclinical hyperthyroidism (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200946). Specificity was 100% (74\u2013100) for both assays in overt hyperthyroidism, and 97% (84\u2013100) and 100% (89\u2013100), respectively, in subclinical hyperthyroidism. When TRAb-IM and TRAb-KR results were used as predictors for recurrence at the time of discontinuation of antithyroid drugs, the ROC AUC was 0.65 (95% CI 0.47\u20130.82;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.07) and 0.57 (95% CI 0.41\u20130.73;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.40), respectively.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The TRAb-IM assay presented better clinical performance at both diagnosis of Graves\u2019 disease and prediction of its recurrence compared to the TRAb-KR assay. Nonetheless, endocrinologists should be aware that both assays are weak in diagnostic of subclinical cases and in the prediction of recurrence, when used at the time of discontinuation of antithyroid drugs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s13044-026-00296-5","type":"journal-article","created":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T12:38:26Z","timestamp":1777379906000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Measuring thyroid-stimulating hormone receptor antibodies using the IMMULITE\u00ae 2000 TSI assay is better than using the BRAHMS TRAK assay in an unselected clinical population, but both perform worse than expected: a real-world retrospective observational study"],"prefix":"10.1186","volume":"19","author":[{"given":"Sofia","family":"Manousou","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anders","family":"Olsson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zoi","family":"Mamasoula","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mina Abdi","family":"Saran","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G\u00f6ran","family":"Oler\u00f6d","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helena","family":"Filipsson Nystr\u00f6m","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,4,28]]},"reference":[{"issue":"6","key":"296_CR1","doi-asserted-by":"publisher","first-page":"899","DOI":"10.1530\/EJE-11-0548","volume":"165","author":"M Abraham-Nordling","year":"2011","unstructured":"Abraham-Nordling M, Bystr\u00f6m K, T\u00f6rring O, et al. 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We did not need to ask patients for individual informed consent as no additional blood was taken and as TRAb-IM and TRAb-KR assays target the TSH receptor. Information about the study was displayed at the Thyroid and Isotope Units during the sampling period.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"Helena Filipsson Nystr\u00f6m has lecture fees from Siemens Healthcare, Oripharm, BMS, and IBSA; was the manager for the National Task Force for Hyperthyroidism in Sweden; and is a Guideline Board Member of European Thyroid Association and the Thyroid Task Force at the Endocrine Society for Endocrinology. The other authors declare no potential conflicts of interest.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"15"}}